Credentialing specialist Jobs in Phoenix, AZ

Job Type

Full-time

Description

Axiom Care is a fast-paced, rapidly growing substance abuse treatment and sober living housing provider with locations in the Phoenix metro area and Apache Junction. We primarily serve low-income and justice-involved individuals who are seeking to change their life for the better. We achieve this by offering multiple levels of care along with medical services, evidence-based professional counseling, case management, housing assistance, employment assistance, and more.

Job Summary

The Credentialing and Billing Assistant will ensure all medical providers maintain current credentials and licenses to work legally in their field or specialty. The Credentialing and Billing Assistant is also responsible for maintaining an active status for all providers and processing insurance claims for medical services rendered and follow claims until paid. This position will also assist patients with HEA Plus applications.

Duties / Responsibilities

• Review documentation for accuracy for coding and billing purposes
• Submit claims and all communications pertaining to the claims being submitted
• Keep and update active reports for billing and billable items
• Utilization review (submitting and monitoring prior authorizations)
• Reviewing denials for reprocessing
• Posting insurance payments against claims in billing software
• Verifying eligibility of clients prior to billing
• Following-up on insurance eligibility for pending enrollments
• Attends meetings as needed for clearinghouse, billing, provider relations, etc.
• Ensures medical providers maintain current credentials and licenses.
• Completes initial and subsequent credentialing packets to active facility payor source.
• Responsible for maintaining current contracts effective and renewal dates for all payors
• Responsible for credentialing all new on-board providers and maintaining current providers on staff
• Responsible for Facility credentialing and follow up
• Review provider files for appropriate documentation required for the credentialing process
• Proficient in data entry
• Completing HEA Plus applications for qualifying patients and tracking the application status
• Coordinating Credentialing and RE-Credentialing applications and conduct document research
• Work with providers to ensure application information is submitted in a timely manner
• Responsible for coordinating, monitoring, and maintaining the credentialing and re credentialling process for health professionals
• Point of contact for credentialing needs for all new providers on staff and on board
• Perform other duties as assigned by management.

Requirements

Required Skills / Abilities

Required Competencies

Education and Experience