Revenue Cycle & Credentialing Coordinator

HospiceCare; South Carolina; On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

403B retirement match

Job summary

HospiceCare seeks a Revenue Cycle & Credentialing Coordinator to support billing oversight, cash receipts, and credentialing across service lines.

You will coordinate payer enrollment, monitor denials, and maintain credentialing files to ensure timely reimbursement and compliance with Medicare, Medicaid, and commercial payers.

Qualifications

• 3+ years in healthcare billing or revenue cycle
• Experience with credentialing and payer enrollment
• Familiarity with Medicare/Medicaid billing rules and HIPAA

Responsibilities

• Support billing oversight and cash receipts processing for hospice/palliative care
• Track accounts receivable and monitor denial trends
• Manage provider credentialing and payer enrollment timelines
• Maintain payer contract documentation and assist with audits
• Prepare reports on credentialing status and revenue cycle performance

Skills

Healthcare billing

Credentialing

Payer enrollment

Data analysis

Excel proficiency

Communication skills

Education

Associate degree in Accounting

Bachelor’s degree preferred

Tools

Microsoft Excel

Job description

Revenue Cycle & Credentialing Coordinator

Department: Finance / Revenue CycleReports To: Chief Financial OfficerLocation: Charleston, WV

Position Summary

The Revenue Cycle & Credentialing Coordinator is responsible for supporting the organization’s revenue cycle operations through billing oversight, cash receipts processing, provider credentialing, payer enrollment, contract administration, and reimbursement support. This position serves as a key liaison between clinical operations, payers, and finance to ensure timely reimbursement, regulatory compliance, and accurate provider enrollment across all service lines.

Essential Duties and Responsibilities

Revenue Cycle Operations

• Assist with oversight of palliative care billing processes.
• Monitor claims submission, payment posting, denials, and accounts receivable follow-up.
• Research and resolve billing discrepancies, rejected claims, and payer issues.
• Coordinate with clinical and operational departments to obtain documentation necessary for claim resolution.
• Track and report revenue cycle performance metrics, including aging, denial trends, and reimbursement concerns.
• Support month-end revenue and receivable reconciliation activities.

Cash Receipts & Payment Processing

• Process and reconcile daily cash receipts and electronic remittance activity.
• Verify accuracy of payments received from Medicare, Medicaid, managed care, and commercial payers.
• Assist with preparation of deposit documentation and cash reconciliation reports.
• Investigate unapplied cash and payment variances.
• Maintain supporting documentation for audit and compliance purposes.

Credentialing & Provider Enrollment

• Manage provider credentialing and recredentialing activities.
• Coordinate payer enrollments, updates, and revalidations for physicians, nurse practitioners, and other providers.
• Maintain credentialing files, licenses, certifications, malpractice coverage, and supporting documentation.
• Monitor enrollment deadlines and renewal requirements to avoid interruptions in reimbursement.
• Serve as primary contact with Medicare, Medicaid, and commercial insurance credentialing representatives.

Contract Management

• Maintain payer contract database and supporting documentation.
• Track contract renewals, amendments, and reimbursement changes.
• Assist leadership with reviewing payer reimbursement terms and contract compliance.
• Coordinate communication regarding contract implementation and updates.

Reporting & Compliance

• Maintain accurate records and documentation supporting billing and credentialing activities.
• Prepare reports related to credentialing status, payer enrollment, reimbursement issues, and revenue cycle performance.
• Support internal and external audits.
• Ensure compliance with Medicare, Medicaid, HIPAA, payer, and organizational requirements.

Qualifications

Education

• Associate degree in Accounting, Business Administration, Healthcare Administration, or related field required.
• Bachelor’s degree preferred.

Experience

• Minimum of three years of healthcare billing, revenue cycle, credentialing, or related healthcare finance experience.
• Hospice, home health, palliative care, or post-acute care experience strongly preferred.
• Experience with Medicare and Medicaid billing processes required.
• Experience with provider credentialing and payer enrollment preferred.

Knowledge, Skills, and Abilities

• Knowledge of healthcare reimbursement methodologies and payer requirements.
• Understanding of provider credentialing and enrollment processes.
• Strong attention to detail and organizational skills.
• Ability to analyze data and identify billing or reimbursement issues.
• Proficiency in Microsoft Excel and healthcare billing systems.
• Strong written and verbal communication skills.
• Ability to handle confidential information with discretion.

We also offer, competitive benefits, 5% employer 403B retirement match, vacation, sick, holiday and personal leave. HospiceCare also participates in the WV Tri-Share Childcare program.