Medical Billing Credentialing Executive

Description:

We are seeking a detail-oriented and motivated Medical Billing Credentialing Executive to join our dynamic team. In this role, you will be responsible for managing the credentialing and re-credentialing process for healthcare providers, ensuring timely and accurate enrollment with insurance payers, and maintaining compliance with industry standards.

Key Responsibilities:

Handle provider credentialing and re-credentialing processes with various insurance payers, including Medicare and Medicaid.

Prepare and submit credentialing applications and documentation accurately.

Conduct primary source verification for provider licenses, certifications, and education.

Ensure timely follow-up with payers to expedite the enrollment process.

Maintain an organized database of provider credentials and monitor expiration dates for renewals.

Collaborate with healthcare providers to gather required information and resolve any credentialing issues.

Stay updated on payer requirements and compliance regulations.

Assist with contract negotiations and payer communications as needed.


Qualifications:

Previous experience in medical billing, credentialing, or a related field.

Strong knowledge of insurance payer requirements and healthcare compliance regulations.

Excellent organizational skills and attention to detail.

Proficient in using credentialing software and tools.

Strong communication and problem-solving skills.

Ability to work independently and meet deadlines.