Billing and Credentialing Director
Limelight Recovery, LLC is a growing, high-end private practice dedicated to promoting wellness in our communities, honoring individual differences, and empowering people to identify their own values on which they can build a life of recovery. We offer a wide range of mental health and substance use services to individuals, families, and groups who are motivated for positive change focusing on marginalized populations who lack access to affordable, quality mental health treatment.
We are seeking a Billing and Credentialing Director to oversee all billing, insurance, and credentialing operations. As the Billing and Credentialing Director, you will manage a team responsible for verifying client insurance coverage, obtaining authorizations, billing insurance companies, and appealing denied claims.
Job Duties/Responsibilities:
- Develop and implement policies and procedures related to billing, insurance, and provider credentialing.
- Ensure timely insurance verification, prior authorizations, claim submission, and payment posting.
- Analyze billing reports and metrics to identify opportunities for improvement.
- Appeal denied insurance claims and resolve billing errors.
- Lead provider credentialing process including license/certificate verification, enrollment, and directory listings.
- Ensure compliance with regulations and payer contract requirements.
- Manage/develop relationships with insurance companies and vendors.
- Recruit, train, evaluate and coach billing staff members.
- Proficiently use Simple Practice software for billing and practice management.
- Obtain and verify Eligibility and Benefits information for patients.
- Submit claims and perform payment posting.
- Conduct thorough Denial Management on a daily basis.
- Maintain sheets and reports on a monthly basis.
- Negotiate credentialing terms with payers.
Requirements:
- Bachelor's degree in business, finance or related field.
- 5+ years experience in healthcare billing required.
- Prior management experience preferred.
- Strong analytical abilities and attention to detail.
- Expert knowledge of medical billing practices, health insurance, CMS guidelines.
- Proficiency with medical billing software, EMR systems, and Simple Practice software.
- Experience in credentialing and payer negotiations.
Skills:
- Professionalism
- Leadership skills
- Techniques to fulfill task requirements
- Timely response
- Positive mindset and attitude
Salary commensurate with experience.
Send cover letter and resume to admin@limelightrecovery.com for consideration.