Medical Billing and Credentialing Expert
Medical Billing and Credentialing Expert
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Job Description
Job Summary:
We are seeking an experienced Athena Billing and Credentialing Expert to manage and optimize our revenue cycle operations. The ideal candidate will have indepth knowledge of Athenahealths billing and credentialing processes ensuring accurate claims submission timely reimbursements and provider enrollment. This role requires strong analytical skills problemsolving abilities and a deep understanding of medical billing coding and insurance verification.
Key Responsibilities:
Billing & Revenue Cycle Management:
- Manage endtoend Athenahealth billing processes including charge entry claims submission payment posting and accounts receivable followup.
- Identify and resolve claim denials rejections and underpayments to maximize reimbursements.
- Conduct audits and analyze revenue cycle performance to improve efficiency.
- Ensure compliance with HIPAA CMS and payer regulations.
- Work with clinical teams to streamline coding and documentation processes.
Credentialing & Provider Enrollment:
- Handle provider credentialing recredentialing and enrollments with insurance payers Medicare and Medicaid.
- Maintain uptodate records for provider contracts CAQH profiles and NPI registrations.
- Track expirations and proactively renew licenses certifications and payer enrollments.
- Liaise with insurance companies to resolve credentialing issues and expedite approvals.
Athenahealth System Optimization:
- Configure and customize Athenahealth workflows to improve efficiency and accuracy.
- Train staff on Athena billing and credentialing best practices.
- Monitor system updates and ensure compliance with new regulations and payer requirements.
Qualifications:
- Required: Minimum 1 year of experience with Athenahealth billing and credentialing.
- Strong knowledge of CPT ICD10 HCPCS codes and insurance guidelines.
- Experience working with Medicare Medicaid and commercial payers.
- Proficiency in resolving denials appeals and compliancerelated issues.
- Excellent analytical problemsolving and communication skills.
- Preferred: Certification in Medical Billing & Coding (CPC CPB) or equivalent.
For interested applicants of referrals please fill out this form https://forms.monday/forms/41e09516ba964ea359fef976ruse1
Or send your resume/CV to
Employment Type
Full Time
