Billing/Credentialing Specialist is responsible for assisting the Billing Manager with ensuring the timely and accurate processing and billing of patient/client insurance, including Medicaid and Medicare. The Billing/Credentialing Specialist will also assist in ensuring that all providers within Pearl Health Clinic are adequately credentialed, following state and federal guidelines and laws. We are searching for a candidate that is a team player, follows direction and treats everyone around them with dignity and respect.

Responsibilities

• Promotes the values of Pearl Health Clinic within the Clinical Departments and the Community
• Complete all clinic billing on a timely and regular basis consistent with federal and state guidelines
• Complete and follow-up on pre-authorizations, patient registration, denied claims, and timely filings
• Ensure that all credentialed providers remain current and are contracted with all possible approved insurance and state entities
• Ensure that the clinic and providers have appropriate licensure to perform services in compliance with federal and state regulations
• Reviewing financial statements for any payment inconsistencies or errors
• Collaborating with clients, third party institutions and other team members to resolve billing inconsistencies and errors
• Finding financial solutions for clients who may need payment assistance
• Informing clients of any missed or upcoming payment deadlines
• Calculating and tracking various company financial statements
• Manage and process appropriate documentation
• Adhere to departmental policies, procedures and objectives, ongoing quality improvement objectives and safety, environmental, and infection control standards
• Maintain patient confidentiality, and comply with all federal and state health information privacy laws

Competencies and Qualifications

• Strong communication, including writing, speaking and active listening skills
• Great customer service skills, including interpersonal conversation, patience and empathy
• Good problem-solving and critical thinking skills
• In-depth knowledge of industry best practices
• Basic math, bookkeeping and accounting skills
• Organization, time management and prioritization abilities
• Ability to be discreet and maintain the security of client information; understanding of industry-specific policies, such as HIPAA regulations for health care
• Effective computer and data entry skills; including to use bookkeeping and account management software in a timely and efficient manner
• Works well in an environment with firm deadlines; results orientated
• Must be able to work independently and part of a team
• Excellent organizational skills
• High school diploma or equivalent. Some college and/or additional education is preferred.

Job Type: Full-time

Pay: $16.80 - $23.10 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No weekends

Work setting:

• Clinic
• Office

Experience:

• Medical Billing and Coding: 3 years (Required)

Ability to Relocate:

• Ammon, ID 83406: Relocate before starting work (Required)

Work Location: In person