Billing and Credentialing Specialist

The Bridge’s mission is to change lives, by offering help, hope, and opportunity to the most vulnerable in our community. We offer a comprehensive range of evidence-based rehabilitative services, including mental health and substance abuse treatment, housing, vocational training and job placement, healthcare, education, and creative arts therapies.

The Billing and Credentialing Coordinator is responsible for coordinating the credentialing process for agency providers. This position will also perform billing for selected programs.

Essential Position Functions:

• Process agency wide provider and agency enrollment, credentialing, and revalidation through CAQH.
• Manage payer-provider roster updates and practice information requests.
• Effectively manage clearinghouse claims issues.
• Manage Excess Income process for all billable programs.
• Analyze and report on accounts receivable.
• Research/Investigate/Resolve and communicate complex eligibility issues.
• Perform other tasks assigned by the supervisor.

Required Knowledge, Skills, and Abilities:

• High school diploma or Equivalent
• Associate degree in healthcare services, health information management, or a related field from college preferred, or a Certificate from a technical school for billing
• Certified Biller or Certified Provider Credentialing Specialist
• Certificate/Diploma or proven knowledge in Medical Reimbursement and Coding
• 3-5 years of healthcare billing and credentialing experience.
• Strong knowledge of Managed Care Payer rules and regulations.
• Knowledge of Medicare LCD and NCCI Edits.
• Knowledge of OMH and OASAS regulations and procedures.
• Versed in third-party payer, Medicaid, and Medicare billing and payment procedures.
• Provider credentialing and Medicaid Excess Income process and procedure.
• Not-for-profit and Behavioral Health regulations.
• General competence with computer systems.
• Knowledge of, NYS ePaces/ eMedNY systems and AWARDS is a plus.
• Experience with clearinghouses.
• Interpersonal skills are required for effective communication/troubleshooting with program personnel and insurance plan contacts.

The Bridge Inc. is an Affirmative Action / Equal Opportunity Employer