Qureos Mentor

Standard High School & College

Job Title: Medical Billing and Credentialing Specialist Company: Deosai Medical Services Location: I-8, Islamabad (On-site) Job Type: Full-time Reports To: Medical Billing and Credentialing ManagerJob Summary:The Medical Billing and Credentialing Specialist at Deosai Medical Services is responsible for overseeing all billing processes and managing provider credentialing. The role ensures timely and accurate submission of claims to insurance companies while verifying the credentials of healthcare providers to maintain compliance with regulatory standards. This specialist will work closely with providers, insurance companies, and internal teams to optimize billing accuracy and ensure proper credentialing.Key Responsibilities:Billing:<ul><li>Submit and process medical claims to insurance companies in compliance with all regulations.</li><li>Ensure accuracy in coding (CPT, ICD-10, HCPCS), modifiers, and documentation before submission.</li><li>Follow up on denied or rejected claims and manage appeals as necessary.</li><li>Track and resolve outstanding accounts receivables.</li><li>Send out patient bills, handle inquiries, and process payments.</li><li>Maintain accurate patient and insurance records</li></ul>Credentialing:<ul><li>Manage credentialing and re-credentialing processes for healthcare providers.</li><li>Ensure all providers comply with state and federal regulations, including licenses and certifications.</li><li>Complete and submit credentialing applications to insurance carriers and healthcare organizations.</li><li>Track credentialing status and resolve any delays or discrepancies.</li><li>Maintain up-to-date provider contracts, credentialing records, and licensing.</li></ul>Compliance &amp; Reporting:<ul><li>Stay updated on billing and credentialing regulations to ensure compliance.</li><li>Generate reports on billing and credentialing activities.</li><li>Assist with internal audits to ensure adherence to best practices and regulations.</li></ul>Collaboration:<ul><li>Coordinate with healthcare providers to gather necessary documentation for billing and credentialing.</li><li>Collaborate with insurance companies to resolve claims and credentialing issues.</li><li>Work with finance and administrative teams to improve the revenue cycle.</li></ul>Qualifications:<ul><li>High school diploma or equivalent required; Associate&rsquo;s or Bachelor&rsquo;s degree in healthcare administration, business, or related field preferred.</li><li>Proficiency in the English language</li></ul>Experience:<ul><li>2+ years of experience in medical billing, coding, and credentialing.</li><li>Strong knowledge of billing practices, insurance regulations, and credentialing procedures.</li><li>Experience with medical billing software and EHR systems (e.g., Epic, Kareo, AdvancedMD).</li></ul>Skills:<ul><li>Knowledge of CPT, ICD-10, and HCPCS coding standards.</li><li>Familiarity with Medicare, Medicaid, and commercial insurance billing processes.</li><li>Strong organizational skills and attention to detail.</li><li>Excellent communication and interpersonal skills.</li><li>Ability to work independently and as part of a team.</li><li>Proficiency in Microsoft Office Suite (Excel, Word).</li></ul>Job Type: Full-timeWork Location: In person

Medical Billing and Credentialing Specialist

Join Standard High School & College and explore 1   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Standard High School & College

About Company

Medical Billing and Credentialing Specialist