Proactive Health

Compensation

Full Description

Salary: $50-60k DOE About Proactive Health Proactive Health is a dynamic and innovative company dedicated to improving patient care for seniors through cutting-edge technology and compassionate service. By blending advanced biometric monitoring with the strength of personal connections, our goal is to empower seniors and their healthcare providers with the data, knowledge, and tools to take charge of their health, reducing readmissions to the hospital and enhancing their quality of life. Job Overview We are looking for a driven Billing & Credentialing Specialist to join our team. This individual will be responsible for assisting with billing, credentialing, and intake. You will help with claims and collections to ensure a smooth process. You will actively work on expanding Proactive Healths insurance footprint in multiple states. You will work with dozens of healthcare organizations at a time to credential our practice. This position is key to our growth as a company. Success will be measured by the number of states we are able to get operational quickly and effectively. Responsibilities & Duties • Overall objective - open up new states through credentialing with healthcare companies and achieve >80-90% In Network rate. • Manage the credentialing process for healthcare providers, including physicians, nurses, and other licensed professionals. • Project management - organize and track all ongoing credentialing projects with the ability to report to the management team on progress at least monthly. • Monitor expiring licenses and credentials, proactively initiating the renewal process to avoid any disruption in services. • Stay up-to-date with industry regulations and requirements, ensuring compliance at all times. • Assist in preparing for and participating in audits and regulatory reviews. • Perform online account status checks and follow up with payers by phone, email, etc. on outstanding claim balances of assigned accounts • Review and verify the accuracy of billing data • Resolve billing issues and discrepancies • Verify insurance benefits for new referrals Qualifications & Skills • Bachelor's degree or equivalent experience in healthcare administration, business, or related field • Certified Provider Credentialing Specialist (CPCS) designation (preferred) • Minimum of 2 years of experience in billing, credentialing, or provider enrollment. • Knowledge of relevant federal and state regulations • Proficiency with credentialing software, databases, and EHRs • Excellent attention to detail and ability to work with complex documents. • Exceptional organizational and time management abilities. • Effective communication and interpersonal skills • Ability to work independently and collaboratively within a team.