Credentialing and Billing Coordinator

Job not on LinkedIn

🔥 0 minutes ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📊 Billing Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 12%

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Physical Therapy & Sports Medicine Centers

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2000

🏥 Healthcare

🧘 Wellness

⚽ Sports

Healthcare • Wellness • Sports

Physical Therapy & Sports Medicine Centers is a privately owned network of outpatient physical therapy clinics based in Connecticut that provides services focused on relieving pain and restoring, maintaining, and enhancing movement. They offer in-person treatments (post-op rehab, dry needling, TPI golf therapy, balance rehab, etc. ), patient resources, a careers center, and virtual physical therapy for residents in selected states. The organization accepts major insurance plans and emphasizes clinical excellence, patient experience, and community reputation.

📋 Description

• Lead insurance credentialing for PTSMC providers and locations • Credential all individual clinicians and provide timely updates • Manage EMR signature rules to facilitate accurate and clean claims submission • Provide insurance carriers with information needed to re-credential current clinicians and locations • Maintain CAQH records for current PTSMC clinicians • Complete applications and learn the credentialing process for participation with new networks • Initiate temporary permit processes and follow up on status when applicable • Track license transfers and follow up as needed • Complete quarterly provider and demographic verifications for participating insurances • Resolve missing or incorrect provider demographic information with payers • Filter and submit claims from the In-Review work queue daily • Correct failed edits, claim rejections, and insurance changes • Resubmit modified or corrected charges after claim addenda are complete • Manage self-pay visits by reviewing patient charges and creating remits to close out visits • Remain current with insurance participation, contract reimbursement, payer guidelines, and policies • Update insurance information and rebill claims to resolve billing issues • Monitor billing on hold for new non-credentialed providers • Review and resolve claims denials related to provider participation • Keep informed of insurance policy changes through website updates and insurance newsletters • Assist with coordination and communication of insurance information for accurate billing

🎯 Requirements

• Detail-oriented • Problem-solving ability • Ability to work collaboratively • Working knowledge of ICD-10 diagnosis codes • Working knowledge of CPT billing codes • Knowledge of billing modifiers • Knowledge of non-reimbursable codes • Knowledge of insurance participation, contract reimbursement, payer guidelines, and policies

🏖️ Benefits

• 401(k) • Dental insurance • Disability insurance • Health insurance • Life insurance • Paid time off