Credentialing & Patient Accounts Specialist

Credentialing & Patient Accounts Specialist – Joint Relief Institute (JRI)

Full-Time | Oakbrook / Orland Park / Stony Island

Summary

The Credentialing & Patient Accounts Specialist is a hybrid role supporting two critical revenue functions for JRI: provider credentialing/payer enrollment and patient accounts/RCM workflows. This role ensures providers remain active with all payers while also assisting with insurance verification, patient account accuracy, administrative denials, and communication with payers and patients. This dual focus protects revenue, reduces delays, and supports clean claims and timely reimbursement.

Key Responsibilities

Credentialing & Enrollment (50%)

• Complete and track all initial credentialing, recredentialing, and payer enrollments.

• Maintain current provider documents: licenses, DEA, malpractice COIs, CME, etc.

• Manage CAQH, NPPES, PECOS, Availity, Medicaid, and commercial payer portals.

• Track expirations, initiate renewals, and maintain up-to-date rosters.

• Communicate enrollment status to RCM, billing, and leadership to prevent claim delays.

• Troubleshoot enrollment rejections, data mismatches, and payer requests.

• Maintain organized, audit-ready credentialing files.

RCM & Patient Accounts Support (50%)

• Verify insurance benefits, coverage limitations, and referral/authorization requirements.

• Support patient financial counseling and explanation of benefits when needed.

• Work denials related to credentialing, eligibility, coverage gaps, and demographic errors.

• Communicate with patients regarding balances, updated insurance, or missing information.

• Partner with billing and coding teams to reduce rejections and increase first-pass acceptance.

• Support revenue cycle projects such as payer audits, roster reconciliation, and reporting.

Qualifications

• 3 years minimum of credentialing, payer enrollment, or RCM experience

• Knowledge of Medicare, Medicaid, and commercial payer rules

• Experience with CAQH, PECOS, Availity, payer portals, and medical billing systems

• Strong understanding of insurance verification and eligibility processes

• High attention to detail and ability to manage multiple deadlines

• Excellent communication and follow-through

Core Competencies

• Detail-oriented and organized

• Strong communicator

• Deadline-driven, proactive, and persistent

• Compliance-minded with understanding of payer and regulatory requirements

• Able to work cross-functionally with billing, providers, and leadership

Suggested Pay Range

$55,000–$65,000, depending on experience and qualifications.