R-Finity Solutions INC is currently looking for Part time/Full time candidates with Billing, Collections, and credentialing experience.
Billing and Collections:
- Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
- Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
- Following up on unpaid claims within standard billing cycle time frame.
- Calling insurance companies regarding any discrepancy in payments if necessary.
- Reviewing patient accounts and follow-up on monthly basis.
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
- Obtaining referrals and pre-authorizations as required for procedures.
Credentialing:
- Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
- Maintains knowledge of current health plan and agency requirements for credentialing.
- Sets up and maintains provider information in online credentialing databases and system.
- Tracks license and certification expiration for all providers to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies, and other entities.
- Processes applications for appointment and reappointment of privileges to The Doctors Clinic (ASC).
- Maintains ASC appointment files, and information in credentialing database.
- Audits health plan directories for current and accurate provider information.
Requirements & Qualifications
Candidates should have experience in medical billing, collections, and credentialing processes including eligibility verification, claims processing, provider credentialing, and use of billing software.
Location
West Virginia, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago