Precise Physical Therapy, LLC dba Preferred Physical Therapy of Kansas City, Kansas is looking to hire an experienced Billing and Credentialing Specialist to join a highly efficient and effective team in KCK. Our new employee will be responsible for both billing and credentialing functions for small and effective Billing Department utilizing electronic medical records (EMR) and clearinghouse interface. This job will require 32+ hours/ wk for the duties described below.
Process and Maintain credentialing/insurance panels on all Clinical Staff.
Set client fees and payment schedules.
Enter payments into the computer billing system
Perform collection activities on all site client accounts in accordance with practice billing procedures
Responsible for running all weekly and monthly reports in accordance with practice billing procedures
High School Diploma or GED. Advanced degree in healthcare or business administration strongly preferred.
Minimum of two to four (2-4) years of experience preferably in a medical staff office, medical billing organization or insurance company in a credentialing capacity.
Must be flexible and demonstrate the ability to work with minimal supervision
Excellent customer service and telephone skills
Experience/ certifications preferred
Ability to deal effectively and tactfully with a wide variety of individuals in person both verbally and in writing.
Ability to work independently and resolve practical problems.
Excellent organizational skills and ability to work well under stress. Accuracy and strong attention to detail.
Excellent computer skills in word processing, spreadsheets, and databases.
Ability to prioritize work and adhere to strict timelines.
Ability to manage and work on multiple projects and with multiple clients simultaneously.
Ability to influence people at all levels including physicians, management and staff employees.
CPCS (Certified Provider Credentialing Specialist) preferred, but not required.
KNOWLEDGE & SKILLS
Healthcare (professional) billing
Efficient use of CPT/ICD-10 coding
Government, managed care and commercial insurances
Claim submission requirements
Reimbursement guidelines and denial reason codes
Understanding of the revenue cycle and how the various components work together preferred.
Excellent organization skills, attention to detail, research and problem-solving ability.
Results oriented with a proven track record of accomplishing tasks within a high-performing team environment.
Strong computer literacy skills including proficiency in Microsoft Office.
Software Operated: Physical/ Occupational Therapy EMR systems and clearinghouse AdvancedMD.
Medical Credentialing Specialist
Essential Functions / Key Responsibilities
Oversee and/or perform all aspects of the licensing, credentialing, and appointment process for our Physical and Occupational Therapists who are prospective and active members of the staff.
Collects and analyzes information, prepares files for approval process and ensures that credentialing files are kept accurate, complete and current.
Assists in the credentialing process for staff, allied health professionals, locum tenens. Work with leadership and clinical staff for the approval and ongoing review of these practitioners.
Ensures malpractice applications are submitted on a timely basis with the carrier to ensure the appropriate level of coverage is maintained for all medical staff members.
Responds to outside inquiries for credentialing information concerning our medical staff.
Assists owner in the facilitation of staff leadership meetings and continuing education events.
Maintain a professional relationship with clients and staff consistently exhibiting the highest level of integrity, respect and good judgment.
Accounts Receivable Specialist is responsible for the accurate and timely follow-up of unpaid claims, by assigned payer/s and defined aging criteria to meet or exceed collection targets and minimize write-offs. Researches claim denials by assigned payer/s to determine reasons for denials correcting and reprocessing claims for payment in a timely manner. Meets or exceeds established performance targets (productivity and quality) established by the A/R Supervisor. Initiates and follows-up on appeals recognizing the payer defined aging criteria. Exercises good judgment in escalating identified denial trends or root cause of denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate first pass resolution. Identifies uncollectible accounts and performs accurate and timely write-offs (e.g. no authorization) adhering to IPM CBO policy guidelines. Demonstrates the ability to be an effective team player and upholds “best practices” in day to day processes and work flow standardization to drive maximum efficiencies across the team.
Benefits These are some of the benefits that the Clinic offers employees: Health, and Dental Insurance, Life/STD/LTD/AD&D, 401k Retirement Plan, Vacation Days, Paid Holidays. (Benefits offered are subject to change.)