Billing Support Specialist

The Billing Support Specialist plays a key role in supporting the credentialing and billing processes within the organization. This individual is responsible for ensuring that all provider credentialing documentation is accurate, up-to-date, and compliant with regulatory and agency standards. In addition, the Billing Support Specialist serves as a backup to the Billing Liaison, assisting with billing-related tasks and ensuring smooth operations during high-demand periods or absences. The Billing Specialist will demonstrate strong attention to detail, communication skills, and the ability to collaborate with cross-functional teams.

Credentialing Support:

• Maintain and update accurate credentialing data for all providers.
• Collaborate with Human Resources to collect and store state licenses, malpractice liability coverage, and other credentialing documents.
• Ensure all credentialing documentation complies with HIPAA and other regulatory requirements.
• Work closely with the third-party billing company to facilitate the credentialing and recredentialing processes.
• Upload required documentation to the third-party billing portal.
• Follow up to ensure timely submission of all necessary paperwork.
• Conduct credentialing sessions during provider orientations to ensure all required documents are gathered.
• Clearly communicate credentialing requirements to new providers and ensure compliance with all necessary standards.
• Assist with ongoing credentialing and recredentialing for behavioral health providers.
• Stay up to date with current credentialing requirements for health plans and regulatory agencies.

Billing Liaison Backup:

• Cross-train in billing liaison responsibilities to provide backup support as needed.
• Assist with the billing process, ensuring that claims are processed efficiently and accurately.
• Work closely with internal teams and third-party billing companies to resolve billing issues and inquiries.
• Assist with the preparation and submission of claims and documentation to ensure timely reimbursement.

Administrative Support:

• Provide ongoing support to HR and other departments as needed, including assisting with HR-related tasks.
• Maintain strict confidentiality of provider data and adhere to HIPAA guidelines and regulations.
• Perform other administrative duties as assigned by management.

Must have at least 2 years of credentialing experience or relevant experience in a healthcare or administrative setting. Experience in billing and administrative support is preferred.