Job Description
Central Dermatology Center is in search of a qualified and resourceful Credentialing with Billing and Coding Specialist for our billing department in ensuring smooth and efficient business operations. This position is responsible for maintaining active status for all providers and patients in a timely and accurate manner, as well as following up on billing tasks, inquiries, and documentation. This position will be approximately 20% Payment Posting, 30% Billing Follow Up and 50% Credentialing.

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Requirements/Qualifications*

• Minimum 18 years of age
• Associates degree or above preferred
• Certifications in Credentialing and Billing is a plus
• Ability to communicate professionally
• Ability to handle multiple tasks simultaneously
• Ability to work autonomously, using discretion as appropriate
• Ability to manage and maintain confidential information
• High proficiency in Microsoft Office
• General knowledge of finance and accounting functions, policies, practice, and terminology.
• Knowledge of billing regulations and processes.
• Ability to analyze, detect and resolve billing issues and reconcile accounts.
• Efficient time
• Strong interpersonal skills, including excellent written and verbal communication skills.
• Strong editing/grammar/punctuation skills.
• Strong attention to detail.
• Strong organizational skills.

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Responsibilities*

• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.
• Credential all new providers and ensure current providers are up-to-date with all insurance plans.
• Maintain internal provider grid to ensure all information is accurate and logins are available.
• Maintain accurate and up-to-date provider profiles on CAQH, PECOS, NPPES, and CMS databases.
• Complete revalidation requests issued by government payers.
• Complete credentialing, re-credentialing, and privileging applications to add providers to commercial payers, Medicare, and Medicaid.
• Work closely with the Revenue Cycle Supervisor and billing staff to identify and resolve any denials or authorization issues.
• Assist patients with billing inquiries, payments, and account discrepancies.
• Post patient payments in an accurate and timely manner to the appropriate line-item charge.
• Research and resolve “unapplied and/or unidentified” payments to ensure monies are properly distributed.
• Identify collection issues with insurance or patient accounts and communicate to A/R team.
• Assist with denials as needed
• Posting of payments received from claims submissions as needed
• Employee Safety: Safely performs all duties: follows required protective protocols to ensure personal safety as well as the safety of others.
• Maintain A/R policies and procedures.
• Other duties as assigned by Supervisor.

Job Type: Full-time

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Vision insurance

Schedule:

• Monday to Friday

Work Location: One location

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