Medical Billing Clearinghouse and Credentialing Specialist

Overland Park, KS

Full Time

Medical Insurance Credentialing Specialist

Mid Level

Medical Billing Clearinghouse and Credentialing Specialist
We are seeking a detail-oriented and highly organized team member with expertise in ERA/EFT processes as well as payer credentialing to play a critical role in managing clearinghouse operations and ensuring client carrier compliance. Join Healthcare Revenue Group (HRG), a thriving medical billing and credentialing company located in Overland Park, KS, as we expand our team.

Responsibilities:

This is an on-site position
Facilitate the enrollment and implementation of ERA/EFT processes for healthcare providers with insurance payers.
Monitor and maintain accurate ERA/EFT records, ensuring timely updates to payer agreements and provider information.
Perform and manage enrollments, re-credentialing, and execute new contract applications with commercial and government health plans on behalf of our diverse client base.
Monitor application progress and proactively follow up as required to ensure timely completion.
Possess comprehensive knowledge of managed care company and plan requirements for efficient credentialing of providers.
Effectively communicate the contracting and enrollment process, addressing client staff inquiries and providing regular status updates to clients and internal stakeholders.
Perform CAQH maintenance for providers, both new enrollments and ongoing updates.
Handle clearinghouse set-up and enrollments.
Maintain and secure insurance website and clearinghouse access credentials.
Be self-motivated to accomplish tasks.

Required Qualifications:

Demonstrated excellence in organization and follow-up skills.
Strong project management abilities, capable of handling multiple applications and collaborating with payers to meet enrollment deadlines.
Self-motivated and able to work independently while diligently monitoring progress.
Exceptional customer service and communication skills.
Profound understanding of managed care companies, plans, and managed care network concepts.
Minimum of 2 years experience in medical credentialing. Experience in Provider Enrollment strongly preferred.
Minimum of 2 years of experience in medical billing, clearinghouse operations, or ERA/EFT management.

Why Choose HRG:

Competitive wages: $20-$25/hr commensurate with experience
Half day Friday from home option (after 90 days, work 4 9 hour days in office, then half day Friday from home)
Comprehensive benefits package
- Health insurance
- Dental insurance
- Vision insurance
- Short-term/long-term disability
- Life insurance
- 401(k) with company match
- 3 weeks PTO
Potential for impactful responsibilities and career advancement.
Job autonomy with a focus on professional growth.
Enjoy a collaborative and friendly team environment.

If you are seeking a fulfilling career opportunity in Revenue Cycle Management, HRG is the place for you! Apply now to become a valuable part of our esteemed team.

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How many years of experience do you have in medical insurance credentialing and provider enrollment? Please provide specific examples of the types of health plans you have worked with in the past.*

Describe your approach to managing multiple credentialing applications simultaneously. How do you ensure timely completion and follow-up with payers to meet enrollment deadlines?*

Communication is crucial in this role. How would you handle explaining the credentialing process and related information to client staff effectively? Give an example of a challenging communication situation you encountered and how you resolved it.*

CAQH maintenance is a critical aspect of provider enrollment. How familiar are you with this process, and what steps do you take to keep provider information up-to-date and compliant?*

The job description mentions a professional and friendly team environment. How do you contribute to a positive team dynamic, and how do you handle collaboration with colleagues to achieve shared goals effectively?*

Have you worked for Healthcare Revenue Group before?*

Please provide a brief summary of your experience enrolling medical providers (on the provider side) in payor contracts and the process you undertake.*

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Please briefly describe your experience with ERA/EFT set up.*

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Medical Billing Clearinghouse and Credentialing Specialist

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