Billing and Credentialing Specialist, Medical Billing & Payer Credentialing
Overview
You will own the full revenue cycle for The Villa Health and The Villa Medical Group, including claim submission, payment posting, denial resolution, and provider credentialing. You will work with administrative and clinical teams to keep operations smooth and patient experience excellent. Join a team that blends evidence-based and holistic care across Oregon and Washington. CPT/ICD-10 coding and EHR proficiency are core to this role.
What You'll Do10
- 1Manage patient registration and verify insurance eligibility and benefits before service.
- 2Submit insurance claims and post payments accurately in EHR systems.
- 3Resolve denied or unpaid claims and reconcile account discrepancies.
- 4Maintain provider credentialing files for all payer types, ensuring current and complete records.
- 5Complete credentialing and re-credentialing applications, track progress, and resolve issues to prevent lapses.
- 6Verify payer provider directory listings and update as needed.
- 7Communicate with payers, clearinghouses, and regulatory bodies on billing and credentialing matters.
- 8Support billing inquiries from patients and payers with clarity and professionalism.
- 9Ensure compliance with HIPAA, payer guidelines, and billing regulations; collaborate on policy updates.
- 10Support an inclusive, trauma-informed culture aligned with The Villa Health’s mission.
Requirements8
- 13+ years of medical billing and credentialing experience in a healthcare setting.
- 2Proficient in CPT and ICD-10 coding and insurance workflows.
- 3Hands-on experience with EHR and billing software.
- 4Strong knowledge of HIPAA and regulatory requirements.
- 5Excellent communication skills for interactions with patients, providers, and payers.
- 6High attention to detail and strong organizational skills.
- 7Comfortable working independently and collaboratively in a hybrid environment.
- 8Ability to maintain confidentiality and follow compliance standards.
Salary Insight
$52 - $62k per year
Location
Required Skills
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