Analyst, AR Credentialing (57790)

ApolloMD; Atlanta, Northern (GA, KY); Hybrid; USD 52,000 - 72,000; Full time

Job summary

ApolloMD is seeking an AR Credentialing Analyst to review and advise on revenue cycle processes related to the billing system. You will help accelerate cash collections through cleaner claim processing and collaborate with Credentialing staff to optimize workflows.

Candidates should have a high school diploma or equivalent; a Bachelor's in Healthcare Administration is a plus. Prior medical billing or credentialing experience is preferred, with strong Excel/Word and familiarity with Athena/CAQH

Qualifications

• High School Diploma or equivalent required.
• Bachelor’s Degree in Healthcare Administration or related field a plus.
• Prior medical billing, credentialing, or data entry experience preferred but not required.
• Ability to interpret Explanation of Benefits from insurance carriers.
• Proficiency with Microsoft Office Excel and Word a plus.
• Athena Collector System, NaviNet, GAMMIS Portal, CAQH, Payspan, Change Healthcare (formerly Emdeon) ProviderNet and VeriNet experience a plus.

Responsibilities

• Work directly with Credentialing staff to enhance workflows within the billing system.
• Analyze the accounts receivables inventory to determine opportunities for systemic resolutions.
• Advise how the organization can eliminate or reduce the amount of holds/tasks
• Work with Athena to optimize workflows within the billing system.
• Work with IT to automate any workflows that can be to eliminate manual workflows.
• Validate provider credentialing information
• Manage provider workflow buckets
• Locate and resolve trending denial codes for payments
• Contact both government and commercial payers daily to resolve provider credentialing issues

Skills

High School Diploma

Bachelor’s Degree

Billing/credentialing experience

EOB interpretation

MS Office proficiency

Education

High School Diploma or equivalent

Bachelor’s Degree in Healthcare Administration or related field

Tools

Athena Collector System

NaviNet

GAMMIS Portal

CAQH

Payspan

Change Healthcare ProviderNet

VeriNet

Job description

AR Credentialing Analyst Job Description

ABOUT APOLLOMD

ApolloMD is a leading Medical Billing company for Emergency, Hospitalist, Anesthesiology, and Radiology Medical services, conveniently located off I-285 in Sandy Springs. Currently serving approximately 1,000 physicians, we support the financial services for more than 2 million patients across the U.S. each year.

Our mission is to maximize the efficiency and performance of our healthcare providers and deliver unparalleled billing and claim support to the patient. To achieve this, we implement leading-edge technology and provide our staff with the knowledge to be successful. As one of the nation’s largest and fastest-growing physician services provider, we offer a competitive salary, and benefit packages. This position supports PaymentsMD, the billing side of ApolloMD.

PERFORMANCE EXPECTATIONS

In performance of their respective tasks and duties all employees of ApolloMD are expected to conform to the following:

• Uphold all principles of confidentiality and patient care to the fullest extent.
• Adhere to all professional and ethical behavior standards of the healthcare industry.
• Interact in an honest, trustworthy and dependable manner with patients, employees and vendors.
• Possess cultural awareness and sensitivity.
• Execute and enforce all organizational policies.

POSITION PURPOSE

To review and advise on all aspects of the revenue cycle process as it pertains to the billing system. Communicate all findings and proposed solutions to enhance the organizations ability to accelerate and increase cash collections through cleaner claim processing.

ESSENTIAL DUTIES, FUNCTIONS & RESPONSIBILITIES

• Work directly with Credentialing staff to enhance workflows within the billing system.
• Analyze the accounts receivables inventory to determine opportunities for systemic resolutions.
• Advise how the organization can eliminate or reduce the amount of holds/tasks
• Work with Athena to optimize workflows within the billing system.
• Work with IT to automate any workflows that can be to eliminate manual workflows.
• Validate provider credentialing information
• Manage provider workflow buckets
• Locate and resolve trending denial codes for payments
• Contact both government and commercial payers daily to resolve provider credentialing issues

This is a full-time, non-exempt role.

Qualifications

REQUIRED EDUCATION AND SKILLS:

• High School Diploma or equivalent required.
• Bachelor’s Degree in Healthcare Administration or related field a plus.
• Prior medical billing, credentialing, or data entry experience preferred but not required.
• Ability to interpret Explanation of Benefits from insurance carriers.
• Proficiency with Microsoft Office Excel and Word a plus
• Athena Collector System, NaviNet, GAMMIS Portal, CAQH, Payspan, Change Healthcare (formerly Emdeon) ProviderNet and VeriNet experience a plus.