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Company Contact Info

  • 262 Washington Street
    Boston, MA 02108
  • Hire Partnership

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Credentialing Specialist

Hire Partnership, LLC • Boston, MA

Posted 18 days ago

Job Snapshot

Full-Time
Healthcare - Health Services
Accounting
12

Applicants

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Job Description

As a member of the team, you’ll help us build a completely disruptive model of care and technology in the mental health and addiction treatment area of the U.S Health Department; you will be a part of something important. We are a young, fast-growing startup and with us, you will shift from having a simple title with limited responsibilities to having a role to play with unlimited possibilities.

Responsibilities:

  • Insurance Claims Submissions- Daily for each clinic assigned.
  • Review claims for proper ICD
  • Accurately post all EoBs/ERAs
  • Make notations in claims history notes on appeals or unexpected claims activity
  • Manage all aspects of Insurance A/R, including Denials, Underpayments, Non-Payments, Appeals, Resubmissions, etc.
  • Monitor Insurance A/R and investigate unpaid claims
  • Identify and track denied and underpaid claims and follow up and repeal results
  • Investigate, correct and resubmit denied claims and track them in a timely fashion
  • Refine and expand Column Health appeal letter templates
  • Monthly Patient Statements
  • Review monthly statements with Revenue Cycle Specialist prior to electronically sending to identify potential unexpected patient balances due to insurance denials, underpayments, etc.
  • Communicate with Clinic Managers
  • Review of problem claims and status of appeals/re-submissions
  • Make notations in patient billing charts on unexpected insurance matters
  • Maintain/Update Fee schedules
  • Work with all new clinicians to ensure proper credentialing
  • Work with Column management to identify billing and revenue opportunities for both existing and new modalities of care
  • Stay up to date on trends in billing and coding; identify and attend periodic relevant continuing education courses
  • Maintain and update logins for various billing and collection sites
  • Work with bookkeeping staff to resolve questions regarding insurance deposits


Job Requirements

Qualifications:

  • Bachelor's Degree
  • Preferably experience working with Athena software.
  • High, positive energy
  • Bilingual candidates are preferred, not required
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