Credentialing Specialist

Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding.

Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies.

Our people are our future – we provide the venue for individuals who have the desire and drive to grow as leaders in the accounting industry. Career paths are not do-it-yourself at MBC. You will be equipped with career development and advocacy experiences, career ladder choices, support in advancing to leadership positions, and a successful integration of your personal and professional life.

Applying today makes you one step closer to joining a firm of enthusiastic, driven, creative and intelligent problem solvers working together toward a common goal – to provide outstanding business solutions.

Position Summary

The Credentialing Specialist will process and maintain all provider and non-provider applications for all physicians and insurance carriers. Handles billing and revenue cycle inquiries as they relate to provider enrollment issues. Serves as a liaison between the respective offices and credentialing department.

Key Objectives

• Responsible for preparing credentialing applications for all carriers
• Responsible for obtaining necessary provider information to complete applications
• Responsible for setting up provider profiles in practice management system and storing of provider IDs in the computer system
• Maintains all group NPI’s and responsible for creating new NPI’s as needed by tax ID and specialty
• Completes and maintains CAQH records
• Maintains Enrollment Worklist and releases claims held for credentialing issues once the issues are resolved or when provider enrolled with payer
• Maintains provider credentialing shared drive spreadsheet for all billing staff and management to utilize
• Produces reports for management staff to help identify and resolve credentialing issues
• Maintains and distributes weekly Physician Insurance Summary Report
• Maintains and updates insurance credentialing information through attending seminars, keeping manuals current, and keeping current mailings on file.
• Assists managers with training and educating employees on the credentialing process
• Serves as a liaison between credentialing, office staff, providers and carriers
• Ability to provide exceptional customer service and meet high proficiency standards, handle confidential information in a private and professional manner
• Coordinate administrative and operational functions for organization
• Ensure clients are assisted in a courteous and expedient manner
• Meet and exceed goals set forth through the annual performance evaluation process
• Growing use and knowledge of applicable company technology, paperless systems, tools and processes

Qualifications

• High School Diploma or equivalent, Associates Degree preferred
• Minimum 2 years’ experience of physician billing and/or credentialing process
• Previous medical office experience preferred
• Must be detail oriented

Preferred Abilities

• Communicate effectively in highly visible and/or adversarial situations
• Actively pursue learning and development opportunities
• Participate actively in all on-the-job and formal learning and development opportunities to understand role and responsibilities
• Ability to accept and adjust to changing priorities and circumstances

Leadership

• Reports to direct supervisor
• Take charge and be action-oriented and persist until the task or job is completed
• Learn and understand how position is critical to the success of the organization and be willing to accept responsibility and be accountable for own actions

Technology

• Experience with Microsoft Office
• Medical Billing workflow software
• Understand and stay current on new technology

Benefits & Perks!

Our commitment is to continually invest in our people, both professionally and personally. That is why our benefits and perks go beyond industry standard. Our offerings include competitive salaries; excellent medical, dental and vision plan options; bonuses; referral programs; life insurance; 401(k) plan; community service opportunities; fun company events; and so much more.

Equal Opportunity/Affirmative Action Employer