Medical Billing and Credentialing Coordinator

Position Summary The Medical Billing & Credentialing Coordinator is responsible for managing insurance billing processes, provider credentialing, payer enrollments, claims follow-up, and revenue cycle support to ensure timely reimbursement and compliance with regulatory standards. This role works closely with providers, insurance companies, and internal staff to maintain accurate credentialing records and optimize billing operations.

Key Responsibilities

Medical Billing

• Submit electronic and paper insurance claims accurately and timely.
• Review claims for completeness, coding accuracy, and compliance.
• Monitor accounts receivable and follow up on denied or unpaid claims.
• Post insurance and patient payments into billing systems.
• Resolve billing discrepancies and insurance issues with payers.
• Verify patient insurance eligibility and benefits as needed.
• Maintain HIPAA compliance and patient confidentiality standards.
• Generate billing and collections reports for management review.

Credentialing & Provider Enrollment

• Coordinate initial and recredentialing applications for providers.
• Maintain CAQH profiles and provider credentialing databases.
• Track license renewals, certifications, DEA registrations, and malpractice insurance.
• Manage payer enrollments and updates with Medicare, Medicaid, and commercial insurers.
• Ensure providers remain compliant with payer and regulatory requirements.
• Maintain organized credentialing files and audit-ready documentation.
• Communicate credentialing status updates to providers and leadership.

Administrative Support

• Collaborate with clinical and administrative teams to improve workflows.
• Assist with policy and procedure updates related to billing and credentialing.
• Support audits and compliance reviews.
• Perform additional administrative duties as assigned.

Qualifications

Required

• High school diploma or GED required; associate degree preferred.
• 2+ years of experience in medical billing, credentialing, or revenue cycle management.
• Knowledge of CPT, ICD-10, and HCPCS coding standards.
• Experience with Medicare, Medicaid, and commercial insurance payers.
• Familiarity with credentialing platforms such as CAQH and PECOS.
• Proficiency with EMR/EHR and medical billing software.
• Strong organizational skills and attention to detail.
• Excellent written and verbal communication skills.

Preferred

• Certified Professional Biller (CPB) or Certified Provider Credentialing Specialist (CPCS) certification.
• Experience in multi-provider or behavioral health practices.
• Knowledge of payer contracting processes.

Skills & Competencies

• Strong analytical and problem-solving abilities
• Ability to manage multiple deadlines and priorities
• High level of confidentiality and professionalism
• Customer service orientation
• Team collaboration and independent work capability

Work Environment

• Remote position
• Prolonged periods of computer and phone use
• Standard business hours with occasional overtime as needed

Compensation & Benefits

• Competitive salary based on experience
• Health, dental, and vision insurance
• Paid time off and holidays
• Retirement plan options
• Professional development opportunities

Equal Opportunity Employer Statement Novus Management Services is an equal opportunity employer and values diversity in the workplace. We encourage applicants from all backgrounds to apply. Pay: $25.00 per hour Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

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