Billing and Credentialing Coordinator
Accounting | Miami, FL | Part Time
Summary / Objective
This position will be responsible for the implementation and evolution of the role. Incumbent’s responsibility is the efficient and timely operations of the Billing and Credentialing division. This will include, but not be limited to responsibility for processing credentialing new and re-credentialing existing providers in both areas of ABA and Mental health. In addition, billing will be processed in a timely manner on a weekly basis for Medicaid and Private Insurance.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Ensure accuracy and completeness of billing information.
- Create and process documentation related to billing.
- Oversee billing process and work with others to resolve issues.
- Review credentialing applications and supporting documents from CAQH or Credentialing packet and follow up on any discrepancies, omissions or missing/required documents;
- Creating new electronic record in the system of record and perform data entry or scanning of all Initial (new) and Reappointment (recredential) Providers credentialing applications and supporting documents;
- Credentialing functions include researching, requesting, and verifying, requesting by telephone, electronically, fax or mailings; State licenses, Liability insurance, National Provider Database (NPI) Report, Office of Inspector General (OIG) reports, Board certification, School/Residency/Fellowship completion, and obtaining additional information or clarification from practitioner as needed;
- Scanning documents received. Creating and/or updating electronic records in the credentialing database by entering data, faxing, and/or scanning;
- Processing practitioner recredentialing application within established deadlines of initial credentialing date.
- Maintaining thorough operational knowledge of the appropriate Credentialing Policies & Procedures;
- Provide input into updating appropriate Credentialing Procedures.
- Tracks and follows up on phone calls, emails, faxes from all sources (insurance companies and practitioners).
- Completes timely requests and submission of credentialing reports or information.
- Maintain patient files.
- Other duties as assigned.
- Analytical Skills - Ability to use thinking and reasoning to solve a problem.
- Detail Oriented - Ability to pay attention to the minute details of a project or task.
- Organized - Possessing the trait of being organized or following a systematic method of performing a task.
- Time Management - Ability to utilize the available time to organize and complete work within given deadlines.
- Ethical - Ability to demonstrate conduct conforming to a set of values and accepted standards.
- Reliability - The trait of being dependable and trustworthy.
- Accountability - Ability to accept responsibility and account for his/her actions.
- Communication - Ability to communicate and express ideas.
- Honesty / Integrity - Ability to be truthful and be seen as credible in the workplace.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.
- Associates degree preferred.
- Two or more years working in administrative/clerical setting.
- Intermediate competency using Microsoft Office.
- Excellent follow-up skills.
- Able to work with minimal supervision and works well in both individual and group environment.
- Knowledge of medical terminology is a plus.
- Ability to analyze data and make appropriate decisions.
- Ability to adhere to HIPPA regulations.
- Good verbal communication skills.
- Fluent in English and Spanish.
- Excellent organizational skills.
- Extremely detail-oriented.
- Ability to maintain confidentiality.
Behavioral Family Solutions, LLC is an Equal Opportunity Employer and it is our policy to provide equal employment opportunities to all people without regard to age, race, color, creed, religion, national origin, disability, gender, sexual orientation, veteran status, or any other basis prohibited by statute, and to promote the full realization of an inclusive employment and service policy.