Billing & Credentialing Specialist

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Requirements:

• High School Diploma.
• Minimum of 2 years’ experience in healthcare billing and credentialing preferred.
• Minimum of 2 years of experience with CMS-1500 (02/12) charge entry, coding, and batch filing.
• Knowledge of CPT and ICD coding along with medical terminology.
• Extremely detail-oriented with strong problem-solving skills.

Responsibilities:

• Support the re-credentialing and CAQH attestation process by verifying provider profiles.
• Assist in collecting and organizing information from providers and malpractice sources.
• Facilitate acquisition and renewal of provider licenses for compliance.
• Collaborate with billing staff to resolve credentialing issues.
• Track and monitor credentialing statuses.
• Act as a liaison between providers and credentialing agencies.
• Scan and organize documents for easy reference.
• Manage claim edits for newly onboarded providers.
• Support Billing by managing claim edits and verifying service locations.