Job Title: Billing & Credentialing Specialist
Position Summary: HopeSparks is seeking a highly motivated, assertive, and strong leader to be our next Billing & Credentialing Specialist. The Billing & Credentialing Specialist is responsible for all aspects of professional credentialing for our Mental Health and Physical Health lines of business as well as provide billing support to the Agency’s Billing Manager and our Children’s Developmental Services Program Billing Clerk. This person must have an impeccable organizational style and be able to successfully engage professional clinicians and insurance representatives alike.
HopeSparks offers a healthy work environment that is not only physically modern and comfortable, but also has competent and cohesive colleagues who foster a supportive and professional atmosphere for all employees. This is an excellent opportunity to be an effective change agent in the healing process of children and families and be a part of a unique team of compassionate individuals.
Must possess a positive attitude with a professional and respectful manner with therapy staff, local pediatricians and insurance company representatives
Must demonstrate strong verbal and written communication skills
Must have 2 years’ experience working with an Electronic Health Records system
Must have a minimum of 2 years’ experience with credentialing as well as working with all aspect of insurance billing. Experience billing for therapeutic services including Mental Health, Speech, Occupational and Physical Therapies preferred.
Must be detail oriented and able to meet strict timelines
Job Responsibilities and Performance Standards for Credentialing:
Initiate the credentialing process with each therapist as needed.
Build provider files – documentation needed, procuring NPI’s as needed, keeping those files current
Fill out all insurance applications and addendums
Assist therapists with the process, disseminate completeness of information provided
Initiate, complete, and maintain two credentialing gatekeeper provider profile sites: CAQH, and Medversant
Re-credentialing all therapist’s as specified by the various health plans
Initiate and maintain “Staff” profiles in ECHO/EHR system
Create new insurance profiles and their billing pathways in ECHO
Maintain Excel spreadsheet’s of our paneled providers to assist Intake with their process
Billing, Intake and therapist resource for insurance contract issues and questions
Communicate all credentialing updates/changes to the appropriate staff
Continual self-education and research on changing WAC’s, contracts, and licensure requirements
Job Responsibilities and Performance Standards for Billing Support:
A/R payment posting
Electronic claim’s support
Client account support
ProviderOne (DSHS) billing
Denied claims research
Work Aging as requested by manager
DCFS and Adoption support billing
Keep current on insurance billing changes, especially Medicaid
CDS billing support as needed.
Help with bank deposit’s as needed by manager
Benefits: Competitive salary with benefits for this full time position.
Application Process: Interested candidates should submit a letter of interest and resume to Corby Bilderback, HR Director. firstname.lastname@example.org
HopeSparks is an Equal Opportunity Employer and does not discriminate against any persons on the basis of race, color, creed, religion, national origin, gender, sexual orientation, age, marital status, disability, or status as a veteran.