Assistant Billing, Credentialing and Provider Enrollment Specialist

Silver Linings is looking for an Assistant Billing, Credentialing and Provider Enrollment Specialist to join our successful team of professionals. We are specifically seeking someone that brings a positive can-do and professional customer-service attitude to our team.  If you are interested in expanding your horizons by joining a growing and thriving company, then we want to talk to you today!

Essential Functions and Job Duties

• Perform insurance verifications (Medicare and commercial payers).
• Responsible for prior authorizations.
• Post payments into EMR system (Integrity Check Point).
• Input manual remits, complete 1500 forms and/or initial filings as needed.
• Download and post electronic remits.
• Review all postings to ensure accurate allocations.
• Research and resubmission of denied claims and/or partial payments.
• Submitting claim appeals as needed.
• Making outbound calls to insurance companies, clients and referral sources as needed.
• Works with clients, Therapists and office staff to assist in billing provider and credentialing matters.
• Accurately documents and maintains client files in company EMR and payer online systems.

• Helps the front office with referrals as needed including but not limited to, communicating estimated client financial responsibility in advance of scheduled services to clients/ POA’s, admin staff and providers as needed.
• Prepare and send invoices and statements for clients.
• Provide correspondence and other clerical activities relative to all primary functions.
• Ensure all existing and new Therapists and provider enrollment and credentialing clients are appropriately credentialed with necessary payors, including renewing credentialing contracts with Medicare/Medicaid and commercial payers.

• Any other tasks delegated by the Billing Manager after being provided with the proper training.

Knowledge, Skills, and Attributes

• Knowledge Medicare and commercial payers as it relates to documentation, reimbursement requirements and current and emerging policies and procedures.
• Ability to read and understand an EOB/RA.
• Proficient in navigating multistep processes with a high attention to detail in a fast and consistent manner.
• A strong commitment to managing client accounts.
• A complete understanding of HIPPA.
• Competent in working with people with mental health concerns.
• Ability to work effectively in a deadline-driven, multi-priority environment; exhibit consistent usage of effective time management skills and appropriate resource management; communicate any concerns and delays to supervisor.
• Provides others with timely and organized information; shares responsibility and accountability; includes and consults with appropriate individuals as needed.
• Provides accurate results that are well thought-out, complete; exhibits high standard for excellence, attention to detail; relays information that is sufficiently detailed and obtains the desired effect from clients.
• Ability to use logical methods to solve problems while producing effective solutions; investigates all appropriate resources for solutions; takes initiative to identify and improve systems and processes in a fast, accurate, and timely manner.
• Ability to relate well with all types of people, attentive and active listener; patience to hear others out and build rapport with respect and diplomacy; ability to effectively manage change and support and promote acceptance; encouraging, motivating, clear and effective communicator.
• Ability to think on their feet while working independently and as a team player.

Experience and Preferred Skills

Minimum of two years of experience in medical billing, credentialing and provider enrollment preferred.

• Associate degree or equivalent experience (preferred).
• Previous experience with insurance/payor contracts managing and maintaining contracts highly preferred.
• Previous experience with MS-Office (Word, Excel, etc.).
• Previous experience EMR/EHR.
• Ability to work in an office environment full-time in Cary, NC.
• Must speak and write fluent English.

This position provides room or advancement for the right professional!