Provider Credentialing/Accounts Receivable Representative

A large, multi-specialty surgical group in Westchester is seeking an Accounts Receivable/Credentialing Representative on a temp-to-hire, or direct hire basis. This position will be fully onsite, Monday through Friday, 9am - 5pm. Our client is seeking candidates who have experience with Provider Credentialing and will provide training on their Accounts Receivable functions. RESPONSIBILITIES: Serving as a liaison between practice, credentialing company, and new/current providers; obtaining all necessary information to complete insurance credentialing, current hospital credentialing/privileges and re-credentialing status, ensure applicable fees and permits are issued and kept current, submit current malpractice liability certificates Organize, file, maintain detailed records of all credentialing and receivables information in designated drives, EMR, and/or other systems Analyze EOB information, co-pays, deductibles, co-insurance, contractual adjustments, underpayments and denial reasons. Review, follow up and respond to inquiries via email, phone or incoming correspondence in a timely manner to resolve outstanding balances, patient complaints or questions regarding the billing process Review patient account balances to ensure all patient payment are applied appropriately. REQUIREMENTS: Experience obtaining the initial status of medical claims by calling insurance carriers and/or checking online web portals Experience with follow up via carrier communication through phone/online web portals to resolve issues and ensure claims are paid timely and appropriately Experience resolving denials and submitting appeals: Identify and resolve denials and payment variances and act to resolve issues through claims reprocessing, claim corrections, and/or drafting and submitting reconsiderations/appeals Proficiency in Microsoft Office Suite including Outlook, Word, Excel and OneDrive Knowledge of CPT/ICD10, medical terminology Familiarity with EMR systems preferably Centricity, ModMed or equivalent High level of customer service & interpersonal skills to work effectively with insurance companies, patients, physicians, and other team members in the practice high level of accuracy and attention to detail, well-organized, self-motivated, and ability to multi-task while working in a fast-paced environment to meet various deadlines Abide by HIPAA and any state and federal laws to remain complaint in accordance with practice policies and procedures Ability to read and interpret explanations of benefits, insurance denials, partials payments, adjustments, and recoupments