Credentialing Specialist Job at North Florida Pediatrics P.A.
Responsible for following up with the processing of claims through insurance carriers and statement for self pay patients. Generate various reports for end of month.
Essential Job Functions
- Verify accuracy of billing data and revise any errors
- Check in Wystar Clearinghouse for any rejected claims
- Follow up with claims as they process through each insurance
- Check for accuracy of payments and ensure the carrier processed correctly
- Create batches
- Adding insurance to patients chart in correct order
- Filing documents in patient charts
- Verifying of active insurances when necessary
- Payment posting of EFTs and ERA
- Payment posting paper checks and virtual credit cards
- Sending and submitting appeals to appropriate insurance carriers
- Post and collect patient payments
- Other duties as assigned
Knowledge, Skills, and Abilities
- Knowledge of several different coding systems, including Level 1 HCPCS and ICD-10
- Ability to think analytically.
- Skill in problem-solving
- Knowledge of various billing software and systems
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
- Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
- Ability to deal with problems involving several concrete variables in standardized situations.
- Able to work independently with minimal supervision.
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