Job Details

SportsMed Physical Therapy is seeking a Medical Biller/Credentialing Specialist to join our team. This position will begin training on site full-time in either Glen Rock, NJ or Franklin Lakes, NJ and will transition to Hybrid-Remote after 2-3 months at the discretion of the billing manager. Thisis a dual-role that combines medical billing/AR with oversight of the provider credentialing process

SportsMed is one of New Jersey's leading providers of physical rehabilitation services. We can offer you a fast paced and challenging career opportunity. If you are passionate about healthcare, motivated and want to make a difference, SportsMed is the place for you.

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Responsibilities

Credentialing Responsibilities

• Oversee the credentialing and recredentialing process for providers and ensure completion in a timely manner
• Maintain provider credentialing database
• Communicate with providers to collect documentation and complete necessary credentialing steps
• Communicate with insurance networks to coordinate provider enrollment
• Monitor credentialing timelines and keep track of necessary recredentialing steps
• Stay informed of industry regulations and credentialing requirements
• Must have knowledge of Pecos, NPPES, and CAQH

• Review new patient records in billing software and initiate billing process
• Work with clinic staff to resolve patient authorization issues
• Review existing claims in billing software and follow up on outstanding issues
• Review outdated claims in billing software to research and resolve as necessary
• Review outdated claims in billing software and prepare for collection as necessary
• Work with insurance companies to resolve billing issues
• Work with patients to resolve billing and collection issues
• Ensure all billing changes, charge offs, escalations, interactions etc. are correctly documented in billing and/or HRM software in a timely manner
• Properly escalate billing issues where necessary
• Follow company processes and procedures carefully
• Prepare and update summary documentation as required
• Other duties as assigned by management

• Minimum 4 years' experience with medical billing required and minimum 2 years' experience with provider credentialing process required
• Solid understanding of medical billing software and procedures preferred (Kareo, WebPT, Navinet, CMD, etc.)
• Knowledge and understanding of Pecos, NPPES, and CAQH
• Ability to multitask and manage time effectively with minimum supervision
• Excellent written and verbal communication skills
• Strong basic Excel skills
• Outstanding problem-solving and organizational abilities
• Keen attention to detail with strong analytical skills
• A professional, courteous, enthusiastic, and conscientious attitude, willing to fulfill group goals and work requirements
• Ability to deal positively with coworkers and supervisors, and support management decisions
• Ability to function as a contributing team member while meeting deadlines and productivity standards
• Out-of-network and in-network billing experience

• Competitive pay based on experience
• Medical, Dental, Vision insurance options
• Life and disability insurance options
• PTO, sick time, paid holidays. 401k
• Excellent career growth opportunities
• Pay Rate $22.00 - $26.00 per hour