Credentialing Specialist


Position Summary

Reporting to the CFO and/or Director of Patient Accounts, the Credentialing Specialist is responsible to accurately process and post daily insurance/patient payments and denials, and to apply the appropriate diagnostic and procedural codes to individual patient health information for data retrieval, analysis and claims processing. Also, responsible to research and resolve trends in insurance denials.

Education & Experience

  • High School Diploma or GED is required
  • Bilingual (English/Spanish) is preferred
  • 1-2 years experience in billing department in medical center, private physicians office or other applicable care setting.

Licensure

  • Medical Billing Certification is preferred
  • Nationally recognized Coding Certification is required of all coders

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