Talent.com
Wolcott, Wood and Taylor, Inc.
Billing Credentialing SpecialistWolcott, Wood and Taylor, Inc. • Chicago, IL, United States
Billing Credentialing Specialist

Billing Credentialing Specialist

Wolcott, Wood and Taylor, Inc. • Chicago, IL, United States
2 days ago
Job type
  • Full-time
Job description

Claims Credentialing Specialist

Chicago

Job Title: Claims Credentialing Specialist

Reports to: Manager of Billing and Collections (AR and Claims)

Summary: The Claims Credentialing Specialist researches the provider claim edits by reviewing internal rosters, state and federal rosters, and NPPE's profile for accurate information. Coordinates any required updates needed with the managed care and WWT credentialing departments for review. Process claims once information is verified and updated by resubmitting all applicable claims.

Essential Duties and Responsibilities:

  • Collaborate with the Managed Care and Internal WWT Credentialing departments to evaluate provider-related claim edits and denials.
  • Liaise with various departments and personnel to facilitate required provider updates for billing purposes.
  • Monitor physician status until updates are marked as "complete."
  • Maintain active rosters received from Payers and/or Managed Care department as a primary reference.
  • Address claim edits and denials stemming from credentialing issues and generate necessary reports.
  • Relay pertinent issues to the relevant credentialing departments and management.
  • Audit credentialing work queues to ensure prompt release of charges held for pending updates in Epic and/or on the NPPES website.
  • Resubmit all relevant denied claims upon completion of updates.
  • Perform additional duties as assigned.

Knowledge, Skills & Abilities:

  • Knowledge of collections, healthcare terminology and office procedures.
  • Attention to detail with the ability to identify/resolve problems and document the outcome.
  • Strong concise, clear written and verbal communication skills.
  • Organizational skills ability to multi-task and work independently.
  • Solid, strong analytical and problem-solving skills.
  • Goal-oriented holds him/herself accountable to achieving shared and personal goals.
  • Establish and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
  • Establish and maintain effective working relationships with employees, departments, and external vendors.
  • Maintains a high level of confidentiality.
  • Advanced skills with Microsoft Office applications: Word and Excel.
  • Excellent time management and workload prioritization skills.

Education/Experience:

  • Minimum two years' experience in revenue cycle processes
  • Ability to demonstrate problem solving, analytical, oral and written communication skills, and the ability to interact professionally with a diverse group
  • Working knowledge of EPIC software desired.
  • Exposure to provider enrollment or credentialing desired.
  • Ability to engage in multiple initiatives simultaneously while working in a dynamic environment subject to impromptu changes in schedules and priorities
  • Proficient in Microsoft Office applications, Outlook and Excel
  • Strong initiative establish goals and take responsibility for meeting them within defined timelines
Create a job alert for this search

Billing Credentialing Specialist • Chicago, IL, United States

Similar jobs

Senior Billing Analyst

HighTower AdvisorsChicago, IL, United States
Permanent

Senior Billing AnalystFounded in 2008, Hightower is a wealth management firm that provides investment, financial and retirement planning services to individuals, foundations and family offices, as ... Show more

 • Promoted

Billing Coordinator

JobotChicago, IL, United States
Permanent

A growing home services company posed for rapid growth.This Jobot Job is hosted by: Kirk MorganAre you a fit? Easy Apply now by clicking the Apply buttonand sending us your resume.Salary: $75,000 -... Show more

 • Promoted

Claim Specialist - Property Field Inspection

State Farm Mutual Automobile Insurance CompanyHIGHLAND PARK, IL, United States
Full-time

US-IL-Chicago;US-IL-Schaumburg;US-IL-Crystal Lake;US-IL-Crestwood;US-IL-Blue Island;US-IL-Tinley Park;US-IL-Hoffman Estates;US-IL-Cary;US-IL-Prairie Grove;US-IL-McHenry;US-IL-Fox River Grove;.Being... Show more

 • Promoted

Automotive Biller

McGrath KIA of Highland ParkHighland Park, IL, United States
Full-time

The McGrath Group is a well-respected, family-owned auto dealership group in the metro Chicago market that has been selling and servicing vehicles in Illinois for decades.Customer satisfaction is o... Show more

 • Promoted

Billing Clerk/LT Clerk

Subaru Evergreen ParkTinley Park, IL, United States
Full-time

The International Autos Group is a family owned and operated group of dealerships serving customers in the Milwaukee, Chicago, and Minnesota.The owner of the organization is Ralph Mauro, the son of... Show more

 • Promoted

Legal Billing Specialist

Sinars Slowikowski Tomaska LLCChicago, IL, United States
Full-time

Legal Billing SpecialistA mid-size Chicago law firm is seeking a highly organized and detail-driven Legal Billing Specialist to join our team.This full-time position offers a competitive salary, co... Show more

 • Promoted

Facility Biller

Insight Health SystemsChicago, IL, United States
Full-time

Insight Hospital and Medical Center Chicago.At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity.Our Chicago ... Show more

 • Promoted

Billing Compliance, Senior Auditor

Endeavor HealthEvanston, IL, United States
Full-time +1

Billing Compliance, Senior Auditor.The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.Reporting to the Manager of Billing Compliance, ... Show more

 • Promoted

Agent in Charge

VeranoHighland Park, IL, United States
Full-time

The Agent in-Charge is responsible for providing exceptional individualized customer service, educational consulting, and in some cases patient record management.In addition, they will provide supp... Show more

 • Promoted

Medical Billing Specialist

destinationone ConsultingChicago, IL, United States
Full-time

Destinationone Consulting specializes in recruitment across diverse sectors, including Healthcare, Health Tech, Government, Municipalities, Non-Profits, Legal, Public Accounting, Food and more.We a... Show more

 • Promoted

Legal Billing Specialist

Greenberg TraurigChicago, IL, United States
Full-time

Legal Billing SpecialistGreenberg Traurig (GT), a global law firm with locations across the world in 15 countries, has an exciting opportunity for a Legal Billing Specialist to join our Revenue Man... Show more

 • Promoted

Billing Analyst (Forensic Services practice)

Charles River AssociatesChicago, IL, United States
Full-time

Billing Analyst (Forensic Services Practice)Charles River Associates is a leading global consulting firm that provides economic, financial, and business management expertise to major law firms, cor... Show more

 • Promoted

Billing Specialist

Publicis Groupe Holdings B.VChicago, IL, United States
Full-time

This is a Hybrid role with 3 days a week in office.This role is located in either New York City or downtown Chicago.We're seeking a detail-oriented and proactive Billing Specialist to join our dyna... Show more

 • Promoted

Billing Manager

chicagotherapycollective.orgChicago, IL, United States
Full-time

Core ResponsibilitiesRevenue Cycle OversightEnsure timely submission of all claims (Medicaid, commercial, private pay)Ensure timely completion of Verification of Benefits and coordinate communicati... Show more

 • Promoted

Medical Billing and Coding - Entry Level Training Program

Dreambound Inc.Highland Park, Illinois, US
Full-time

Note : This is an educational program, not a job.Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market.Looking to ... Show more

 • Promoted

Remote Macroeconomic Modeling Specialist (EViews)

Micro1Zion, Illinois, US
$35.00–$100.00 hourly
Remote
Full-time

Macroeconomic Modeling Specialist (EViews).AI data lab for training frontier models and evaluating AI agents.Experts contribute their diverse subject matter knowledge across domains such as finance... Show more

 • Promoted

Licensed Tax Accountant In-Store

IntuitHighland Park, IL, United States
Full-time

Intuit is seeking highly motivated individuals to join our dynamic team as dedicated year-round TurboTax Retail Experts in one of our TurboTax Retail or Flagship locations across the United States.... Show more

 • Promoted

Billing Director (Location Flexible)

RSMChicago, IL, United States
Full-time

The Billing Director provides leadership to and oversight of the Firm's billing function for their respective line of business focus area(s).The position is responsible for ensuring the most effect... Show more

 • Promoted

Billing Manager - Corporate

Foley & Lardner LLPChicago, IL, United States
Full-time

Foley & Lardner LLP is seeking a Billing Manager to lead our Business Law billing team.The Billing Manager is responsible for strategically designing, implementing, and continuously enhancing the b... Show more

 • Promoted

Medical Billing Specialist

Revel StaffingTinley Park, IL, United States
Full-time

Medical Billing SpecialistA confidential healthcare billing organization is seeking an experienced Medical Billing Specialist.This role is fast-paced and high-volume, requiring exceptional accuracy... Show more