Medical Credentialing and Billing Specialist

MediTelecare
Middletown, CT Full Time
POSTED ON 4/8/2024

MediTelecare is the nation’s leading telemedicine provider of behavioral health care to skilled nursing, assisted living and independent living facilities seeks an experienced full-time Revenue Collection Manager.   The Revenue Collection Manager (RCM) will manage the patient intake function and denial management functions. The daily functions of the RCM Manager include monitoring denials, working with an outsourced billing company, updating insurance information, KPI management, and managing the patient intake processes.

Job Summary:

The Medical Revenue Cycle and Enrollment Manager will manage the provider enrollment process of a Company operating in 26 states. The daily functions of the position include managing the credentialing/enrollment functions, monitoring denials, working with an outsourced billing company, updating insurance information, and KPI management.

Duties/Responsibilities:

  • Medical front office or medical office operations experience required, ability to manage turn over, experience with interview, hiring and staff onboarding.
  • Review new provider enrollment information to determine all issues that need to be addressed.
  • Maintain provider information via provider enrollment software including demographics for all providers. 
  • Continually follow up with payers to ensure timely enrollment and participation, including revalidation dates.
  • Coordinate with internal team and outside Revenue Collection Management (RCM) company to monitor and manage key revenue cycle activities including billing, collections, payment posting, and rejection/denial management.
  • Proactively identify, troubleshoot, and resolve RCM issues to improve timeliness and effectiveness of the revenue cycle process.
  • Manage enrollment and credentialing personnel both internal and external to the Company.
  • Draft and implement processes and procedures to improve efficiency and accuracy.
  • Understand EHR/PM systems, patient scheduling, insurance requirements, pre-authorization requirements and impact on care delivery.
  • Data analysis skills using Excel (pivot tables)
  • Ability to identify and report on trends and patterns for the activities assigned to their department.
  • Utilization of KPIs to manage the department.
  • Performs other duties as assigned.

Required Skills/Abilities:

  • Excellent verbal and written communication skills.
  • Excellent organizational skills and attention to detail.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Strong analytical and problem-solving skills.
  • Ability to prioritize tasks and to delegate them when appropriate.
  • Ability to act with integrity, professionalism, and confidentiality.
  • Thorough knowledge of medical billing laws and regulations.
  • Proficient with Microsoft Office Suite.
  • Proficiency with Electronic Health Record Systems

Education and Experience:

  • Bachelor’s degree in Business Administration, Human Resources or related field required.
  • At least 7 years of medical billing experience.
  • At least 3 years of experience managing a team.

 

 

Salary.com Estimation for Medical Credentialing and Billing Specialist in Middletown, CT
$54,366 to $69,087
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