Qualifications

Credentialing Specialist – Key Responsibilities:

• Provider Enrollment: Enroll healthcare providers with insurance companies, validate enrollments, and submit applications.
• Application Follow-Up: Track and follow up on submitted applications to ensure timely processing.
• Portal Creation: Develop and manage portals to facilitate the billing process.
• Direct Deposit Setup: Initiate setup for direct deposit transfers from insurance companies to providers.
• Electronic Remittance Advice: Implement ERA to streamline payment collection.
• Client Communication: Communicate with clients to resolve enrollment issues and provide support.

Billing Specialist – Duties & Responsibilities:

• Billing Management: Oversee billing processes for therapy services to ensure accuracy.
• Insurance Verification: Verify insurance coverage and process claims accurately to ensure timely reimbursement.
• Patient Inquiries: Address patient questions regarding billing and insurance matters promptly and professionally.
• Compliance Collaboration: Work closely with healthcare providers to ensure compliance with billing regulations.
• Record Keeping: Maintain accurate records and generate detailed reports

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