Billing Manager and Credentialing
On-site · Youngstown, Ohio, United States
Job Summary
Billing & Credentialing Manager responsible for overseeing all billing operations and credentialing processes to ensure accurate, timely claim submission and compliance with healthcare regulations. Manages billing staff, monitors workflows, resolves claim issues, and collaborates with internal departments to optimize reimbursement and revenue cycle performance. Oversees billing functions including claim generation/submission/follow-up for Medicaid, MCOs, and SmartCare; maintains billing batch logs; processes deposits; investigates and corrects failed/denied claims; ensures credentialing for providers across COMPASS locations; completes credentialing within 14 days of employment; maintains insurance contracts and provider eligibility; serves as liaison between billing and clinical departments; leads and supervises staff; identifies workflow improvements; ensures regulatory compliance. Qualifications include 3+ years in medical billing, Medicaid/commercial billing knowledge, CPT coding, Credible or similar systems, strong Excel/Office skills, and excellent communication and organizational abilities. Prolonged sitting with occasional standing; occasional lifting up to 25 pounds.
Required Qualifications
- Minimum of 3 years in medical billing (required)
- Knowledge of Medicaid and commercial insurance billing (required)
- CPT coding and claim accuracy
- Electronic healthcare billing systems (e.g., Credible)
- Strong attention to detail and organizational abilities
- Advanced proficiency in Microsoft Excel and Office Suite
- Excellent communication and problem-solving skills
- Ability to manage multiple priorities and meet deadlines
- Prolonged periods of sitting and occasional standing/walking
- Frequent use of hands for computer work and office equipment
- Ability to lift up to 25 pounds
- Leadership and team management
- Analytical thinking and process improvement
- Regulatory compliance awareness
- Revenue cycle optimization
- Cross-functional collaboration
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