Medical Billing & Credentialing Specialist

5550 Venture Drive Parma, OH 44130 Business/After Hours: 216-201-2000 Tell Us How We're Doing • Home • PROGRAMS • BUSINESS • A-Z INDEX • FORMS • ABOUT • CONTACT • HOT TOPICS My Account Job Openings >> Medical Billing & Credentialing Specialist Medical Billing & Credentialing Specialist

Summary

Title: Medical Billing & Credentialing Specialist ID: 1245 Location: Parma, Oh Department: Administrative Salary : $36,504 annually Hours: Mon-Fri., 8:30am to 4:30pm More about this job > Description POSITION AVAILABLE Position: Medical Billing & Credentialing Specialist Reports to: Chief Financial Officer Position to be filled: April 7, 2025 Starting Salary: $36,504 annually Hours: Mon. - Fri., 8:30 a.m. to 4:30 p.m. Vaccine Policy: All new hires will need to meet COVID and Influenza vaccine requirements or request an exemption and submit a TB Baseline as outlined in the CCBH Vaccination Policy. Direct service employees will need to meet Hepatitis-B vaccine requirements or request an exemption as outlined in the CCBH Vaccination Policy. Minimum Requirements: • Associate's degree in health information management technology or related field or two years of direct experience. • Minimum of three years of medical office and medical billing with collection experience. OR five years of experience (with HS Diploma/GED), OR one year of experience (with Bachelor's degree), OR no experience necessary (with Master's degree). • Certified Medical Coder and Certified Medical Insurance Specialist credentials. • Ability to efficiently multi-task on a daily basis. • Strong knowledge of medical terminology, billing/collection processes, and insurance billing and coding (ICD-10 and CPT). • Knowledge of local, state, and federal billing regulations and third-party insurance program requirements. • Proficiency with use of databases for data querying and reporting. • Proficiency with use of PC hardware & basic software (i.e., Microsoft office), email, and office equipment (i.e., copier, fax, scanner, telephone, etc.). • Strong customer service, verbal and written communication skills, and organizational skills. Good interpersonal relationship skills including cultural sensitivity & competence. Responsibilities: • Maintains up to date knowledge of third-party billing procedures and regulations in accordance with HIPAA, CMS, the ACA, etc. Leads the claims resolution process on behalf of the agency with third party providers. Provides assistance with the development, implementation and/or revision of policies/procedures governing CCBH's medical billing process. • Revises, corrects, and codes medical charges into the billing system. Enters/updates medical charges into billing system. Addresses and resolves billing discrepancies with third party providers. • Verifies insurance eligibility and level of benefit coverage for clients. • Reviews all medical claims for accuracy prior to submission to the medical claims clearinghouse for payment processing. Collaborates with third party providers to resolve claims issues on agency's behalf. • Assists with the updating and maintenance of the clinic fee schedule utilizing the CPT, HCPCS, and ICD-10 code databases. • Maintains up to date knowledge of the latest methods of data collection, coding, billing, collection, and claims submission. Serves as a resource to clinic staff related to the medical coding/billing process. • Receives and posts daily revenue from insurance carriers and direct client payments into the billing system and reviews and remedies any denials. Confers with the insurance carrier and/or clinic staff to resolve any discrepancies. Generates invoices to clients for balances owed. • Performs periodic reviews of CCBH contracts and agreements to ensure availability of the most current information for all medical insurance carriers, CCBH, and its providers. Consults with CCBH General Counsel for contract approvals and collaborate with the relevant clinic supervisory staff. • Completes/updates provider enrollment credentialing and credentialing process. Maintains timely and accurate entry of provider data in CAQH and all other required databases. Monitors expiring licensure, board and professional certifications, and other documents that expire for all providers and ensure timely renewals. • Collaborates with internal and external partners on special projects as assigned. Participates on internal and external subcommittees. • Develops and extracts reports from databases (i.e., EHR, etc.) for delivery to internal and external customers. Creates and runs regular reports for collections, billing, program statistics, etc. Gathers and organizes documents to satisfy client record audits or other reporting obligations. • Participates in public health emergency activities as needed. • May be required to operate agency-owned fleet vehicles at offsite service locations. • Performs other duties as assigned. Please complete the online application on our website, www.ccbh.net/jobs All applicants are required to upload a resume and include a cover letter with their application. Deadline to Apply: February 7, 2025 Bilingual Applicants Welcome Benefits offered at CCBH (for employees working at least 40 hours per pay period/Bi-weekly): • Medical (full time employees responsible for 10% of premium) • Dental (full time employees responsible for 10% of premium) • Vision • Public Employee Retirement System (PERS) • Deferred Compensation • FSA Health and Dependent Care • Tuition Reimbursement • Holidays (14 paid per year) • Vacation Time (13 paid days per year for new service PERS members*) • Sick Time (15 paid days per year*) • Personal Days (up to 3 paid per year) • Agency paid Life Insurance • Additional Voluntary Life Insurance • Voluntary Identity Theft Protection • Voluntary Critical Illness • Voluntary Accident Insurance • Employee Assistance Program • Free Parking Onsite • Remote work from home available up to two days per week with approval after the completion of a minimum of 60 days of employment. • Alternate work schedule or changes in work schedule available after initial training period with approval. Core work hours of 10am to 2pm required of all staff. • Benefit is prorated based on start date Employees hired for a position that is funded in whole or in part by a designated funding source may be laid off when the funding source is reduced or eliminated. THIS AGENCY IS AN EQUAL PROVIDER OF SERVICES AND AN EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER CIVIL RIGHTS ACT 1964 THIS EMPLOYER PARTICIPATES IN E-VERIFY All employees hired for a position must be legally authorized to work in the United States without requiring sponsorship for employment visa status now or in the future. Apply Now Refer to a Friend Copyright 2025 Cuyahoga County Board of Health. All rights reserved. Powered by ApplicantStack Hiring Software • Home • PROGRAMS • BUSINESS • A-Z INDEX • FORMS • ABOUT • CONTACT • HOT TOPICS Apply Job!