Revenue Cycle & Credentialing Specialist

• Flexibility: Productive hybrid or fully remote work options.
• Growth: Be a key player in a rapidly growing healthcare organization.
• Support: A collaborative management team focused on your professional success.
• Benefits: Insert Benefits Here e.g. Health Vision PTO 401k - Highly recommended for CareerPlug visibility

• Prepare and submit accurate provider enrollment and credentialing applications to Florida Medicaid and Managed Care Organizations (MCOs).
• Proactively monitor and track application statuses from initial submission through final approval.
• Organize and maintain all credentialing files payer contracts and official documentation.
• Coordinate and execute re-credentialing processes well ahead of expiration deadlines.

• Oversee daily electronic claims submissions and verify accuracy prior to transmission.
• Research correct and resubmit rejected claims and draft effective appeals when necessary.
• Monitor outstanding unpaid claims and maintain consistent communication with insurance representatives.
• Accurately post payments and process necessary claim corrections within the billing system.

• Track accounts receivable (A/R) to identify trends reduce outstanding balances and improve overall collection rates.
• Prepare and deliver clear monthly billing and financial reports for the management team.
• Maintain strict HIPAA compliance and adhere to all regulatory payer and state guidelines.
• Assist management and external auditors during administrative or financial reviews.

• Experience: Minimum 3 years of medical billing AND 2 years of provider credentialing experience.
• Regional Knowledge: Deep familiarity with Florida Medicaid regulations and Managed Care Organizations (MCOs).
• Technical Skills: Hands-on experience with electronic claims submission platforms.
• Communication: Excellent written and verbal communication skills to successfully navigate insurance provider networks.
• Core Traits: Highly organized detail-oriented and capable of managing workloads independently.

• Industry Background: Prior experience in home care or home health settings.
• Software Proficiency: Experience using WellSky Availity and the FL MMIS portal.
• Payer Programs: Familiarity with Medicare billing protocols.

• 30 Days: Complete onboarding learn HomeWell workflows and audit current Medicaid/payer enrollments.
• 60 Days: Clear pending credentialing applications and begin managing the billing cycle independently.
• 90 Days: Fully own the billing and credentialing processes while successfully reducing claim denials.

• Submit credentialing applications within 5 business days of receipt.
• Transmit electronic claims within 48 hours of service completion.
• Maintain a claim acceptance rate of 95% or higher and a denial rate below 5%.
• Keep Accounts Receivable (A/R) under 45 days.
• Deliver monthly financial reporting by the 5th business day of each month.

AtHomeWellCare Services we pride ourselves on providing the highest quality care for seniors and others needing individualized support and companionship athome. With locations across the U.S. we offer many opportunities for compassionate individuals who enjoy improving the quality of life of those around them with numerous positions for varying levels of expertise such as companion caregivers certified aides and case managers.

This franchise is independently owned and operated by a franchisee. Your application will go directly to the franchisee and all hiring decisions will be made by the management of this franchisee. All inquiries about employment at this franchisee should be made directly to the franchise location and not to HomeWell Care Service Corporate.