Medical Staff Credentialing Director is responsible for all aspects of the verification process for medical staff incumbents. Provides regulatory oversight and guidance to the credentialing process. Being a Medical Staff Credentialing Director maintains working knowledge and ensures continuing compliance with state, federal, and institutional standards and guidelines. Develops and implements policies and protocols related to medical staff verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Additionally, Medical Staff Credentialing Director analyzes reports on applications and credential status to identify trends and improve the credentialing process. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to senior management. The Medical Staff Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Medical Staff Credentialing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
Job Summary:
We are a fast-growing Internal Medicine, Hematology and Oncology private practice seeking a skilled and detail-oriented Medical Biller to join our team. The Medical Biller will be responsible for accurately coding and billing medical procedures, ensuring timely reimbursement, and maintaining patient records. The ideal candidate will have a strong understanding of medical coding systems with specific experience and knowledge of oncology/hematology billing and coding, excellent attention to detail, and the ability to work in a fast-paced medical office environment.
Duties:
- Review and analyze medical documentation to assign appropriate codes using DRG, ICD-9, ICD-10, and other coding systems
- Ensure accurate and timely submission of claims to insurance companies
- Follow up on unpaid claims and denials, and resolve any billing discrepancies
- Process payments from insurance companies and patients, and post them to patient accounts
- Maintain patient records, including demographic information, insurance details, and billing history
- Collaborate with healthcare providers to obtain necessary documentation for accurate coding and billing
- Stay updated on changes in coding regulations and requirements
- Assist with medical collections as needed - Physician credentialing and accreditations (hospital, insurances, etc.) - Stay updated with, and timely submission of, CMS quality Reporting and Value-Based Programs and Initiatives and other Quality-Based Measurements and Incentives - Stay updated and comply with HIPAA regulations in collaboration with the physicians and medical and office staff
Requirements:
- Certification in medical billing or coding; College graduate preferred
- Proven experience as a Medical Biller and Credentialing Specialist
- Strong knowledge of medical terminology, coding systems (DRG, ICD-9, ICD-10), and medical office procedures
- Proficient in using electronic medical record (EMR) systems and billing software
- Excellent attention to detail and accuracy in coding and billing processes
- Strong analytical and problem-solving skills
- Ability to work independently and as part of a team in a fast-paced environment
We offer competitive pay based on experience.
If you are a dedicated Medical Biller with a passion for accuracy and efficiency in healthcare billing, we would love to hear from you. Please submit your resume for consideration.
Job Type: Full-time
Pay: From $67,000.00 per hour
Expected hours: 40 per week
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Work Location: In person
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