We are seeking a detail-oriented and proactive Credentialing & Billing Specialist to join our healthcare team. In this role, you will oversee the credentialing process for healthcare providers, ensure licenses, certifications, and credentials remain current and compliant, manage billing operations, verify insurance information, and support accurate claim submissions. You will help maintain seamless payer enrollment and uphold healthcare compliance standards in a dynamic medical environment.
• Proven experience in managed care environments or healthcare administrative roles with a focus on credentialing or billing. • Strong knowledge of health insurance policies, payer enrollment procedures, and CMS regulatory compliance standards. • Proficiency with medical credentialing software applications and healthcare software systems used for database management and billing. • Familiarity with medical terminology, contract management in healthcare settings, and healthcare compliance regulations including NCQA standards. • Experience reviewing medical credentialing applications for accuracy and completeness. • Excellent organizational skills and ability to manage confidential information securely. • Ability to interpret complex healthcare regulations and apply them in administrative workflows.
Location
Alabama, US
Employment Type
Full-time
Experience Level
Associate
Salary Range
$1 - $1
Remote work allowed
No
Posted
1 month ago