Medical Biller & Credentialing Specialist - Onsite at GeBBS Healthcare Solutions, Inc.

New York, New York, United States -

Full Time

Start Date

Immediate

Expiry Date

08 Sep, 26

Salary

0.0

Posted On

10 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Billing, Provider Credentialing, Claims Submission, Insurance Verification, Denial Management, CPT Coding, ICD-10 Coding, HCPCS Coding, EMR Systems, HIPAA Compliance, Payment Posting, Regulatory Compliance

Industry

Hospitals and Health Care

Description

Description The Billing and Credentialing Specialist is responsible for medical billing processes and overseeing provider credentialing activities. This role ensures accurate and timely claim submission, reimbursement, and compliance with payer requirements while maintaining provider credentials with insurance networks and regulatory bodies. This role is onsite in Jamaica, NY. Requirements Billing Duties Prepare, review, and submit medical claims to insurance carriers in an accurate and timely manner Verify patient insurance coverage and benefits prior to billing Monitor claim status and follow up on unpaid or denied claims Resolve billing discrepancies and work with payers to ensure proper reimbursement Post payments, adjustments, and denials into the billing system Maintain compliance with payer guidelines and healthcare regulations (HIPAA, etc.) Communicate with patients regarding billing inquiries and payment options Credentialing Duties Manage the credentialing and re-credentialing process for healthcare providers Prepare and submit credentialing applications to insurance companies and regulatory agencies Track application status and follow up to ensure timely approval Maintain up-to-date provider records, licenses, certifications, and continuing education Ensure providers are enrolled and active with appropriate payer networks Monitor expiration dates and renew credentials as needed Maintain compliance with organizational policies and industry standards Qualifications High school diploma or equivalent required; associate or bachelor’s degree preferred 3+ years of experience in medical billing or credentialing, or a related healthcare role Knowledge of CPT, ICD-10, and HCPCS coding preferred Familiarity with insurance verification, claims processing, and denial management Experience with credentialing software and electronic medical record (EMR) systems Strong attention to detail and organizational skills Excellent communication and problem-solving abilities

Responsibilities

The specialist manages medical billing processes, including claim submission and reimbursement, while overseeing provider credentialing with insurance networks. They ensure compliance with healthcare regulations and maintain up-to-date provider records and licenses.