Billing and Credentialing Specialist at Serna Solutions LLC

Albuquerque, New Mexico, United States -

Full Time

Start Date

Immediate

Expiry Date

01 Jun, 26

Salary

72000.0

Posted On

03 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Billing, Credentialing, Claims Submission, Denial Resolution, Payment Reconciliation, Insurance Eligibility Verification, Record Keeping, Client Communication, Payment Plan Management, HIPAA Compliance, Electronic Health Record Systems, Teamwork, Emotional Intelligence, Customer Service, Proactivity, Communication

Industry

Mental Health Care

Description

Description Location: Albuquerque or Santa Fe, NM. Type of Employment : Full-Time with Benefits (health, vision, dental, vacation, holidays, plus five mental health days per year and 401k after one year of service) Salary: $60,000- $72,000 annually, based on experience and specialized skills (such as bilingual abilities or behavioral health billing). Opportunities for advancement in salary and responsibilities are available. Work Schedule: Weekdays, primarily some flex scheduling possible · Health care benefits for full-time employees are paid at 65% of the cost (these rates can vary year to year as we negotiate contracts with our insurance carrier). · Two weeks of paid vacation per year · Thirteen paid holidays per year · Paid sick leave · Five mental health days per year · Participation in our 401K Plan, after one year of service during one of two enrollment periods. Requirements Required Qualifications and Skills High School Diploma or higher is required. At least 2 years of medical billing experience, preferably in a behavioral health or outpatient setting, required. Certification as a Medical Biller and Coder is preferred. Effective written and verbal communication skills. Ability to complete and submit documentation of services and other paperwork in a timely manner. Comfort and familiarity working with a diverse client base. Proficient in the use of standard office technology (computers, email, etc.) and Electronic Health Record systems. Personal Qualities Well organized Able to communicate and work effectively with a team High level of integrity and honesty High degree of emotional and relational intelligence Customer service/client orientation Proactive and able to anticipate the needs of the CEO and organization Responsive to evolving business needs and priorities Responsibilities and Duties Revenue Cycle Management Prepare, review, and submit insurance claims accurately and promptly. Track claims throughout the payment process and resolve rejections or denials. Monitor and reconcile insurance and client payments, ensuring all revenue is properly recorded. Assist with payment recovery and follow up on outstanding balances. Track payments. Credentialing and Eligibility Assist with provider credentialing and re-credentialing for insurance panels. Verify client insurance eligibility and benefits prior to appointments as needed. Maintain organized and up-to-date records for credentialing and billing documentation. Client Financial Coordination Communicate with clients about account balances and billing questions. Establish and manage payment plans according to clinic policies. Provide outstanding customer service when discussing financial options and resolving billing issues. Administrative Support Build and maintain positive relationships with insurance provider representatives. Answer phone calls and assist clients and staff with billing inquiries. Provide coverage for scheduling staff as needed. Maintain compliance with HIPAA and confidentiality standards. Professional Development Complete all required training for Serna Solutions. Review and comply with all state regulations, code of ethics, and insurance protocols relevant to the position. Participate in ongoing training and professional development opportunities. Adhere to all company policies and ensure you stay updated with any new policies as required during

Responsibilities

The role involves comprehensive revenue cycle management, including preparing, submitting, tracking, and reconciling insurance claims and payments, alongside assisting with provider credentialing and verifying client insurance eligibility. Additionally, the specialist will handle client financial coordination, answer billing inquiries, and provide administrative support while maintaining compliance with HIPAA.