Primarily remote work with meeting in person on a necessary basis
Verify coverage and eligibility for medical services
Communicate with insurance providers and patients
Review patient bills and correct any missing or inaccurate information
Use a billing software to prepare and transmit claims
Clear up balance discrepancies
Investigate and appeal claims that were denied
Complete data entry to update spreadsheets and reports
Work with patients to set up payment plans
Adapt to updates and changes in billing software
Process denial management for claims rejected by the Insurance companies
Create and maintain licensing, credentials and insurance records
Conduct research on updated state and federal regulations and policies
Release information to requesting agencies and public inquiries when required by law
Help develop internal credentialing processes
Monitor license and credential expiration dates and advise staff members of required “renew by” dates
Ensure the facility and staff members are maintaining compliance with regulatory and accrediting institutions
What You Should Have :
Proficiency with computers and medical billing software
Knowledge of unfair debt collection practices and insurance guidelines
Understanding of primary code classifications : ICD-10-CM, ICD-10-PCS, CPT and HCPCS
Communication skills with patients / healthcare companies
Basic accounting and bookkeeping practices
Bachelor's or Associate's degree preferred
Minimum of 1 years of healthcare billing and credentialling experience
Passion for healthcare and technology
Exceptional written and verbal communication skills
High degree of professionalism
Strong customer relationship management skills
Ability to foster strong, positive relationships
Proven ability to set goals and meet deadlines
Understanding of healthcare billings and credentialling industry
Certified Provider Credentialing Specialist (CPCS) certifications – Is a plus
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Medical Medical • hyderabad, telangana, in
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