Guidance Center of Lea County, Inc. · 13 hours ago
Billing/Credentialing Technician
Hobbs, NM, US
Full-time
Onsite
New Grad, Entry Level
$16/hr - $22/hrGuidance Center of Lea County, Inc. is seeking a Billing/Credentialing Technician responsible for managing the credentialing and privileging processes for healthcare providers. The role involves maintaining provider data, ensuring timely license renewals, and managing insurance claims submissions and follow-ups.
Health CareNon ProfitRehabilitationWellness
Responsibilities
Responsible for ensuring providers are credentialed, appointed, and privileged with health plans, MCOs and patient care facilities; monitors applications and follows-up as needed
Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications
Maintains copies of current state licenses, certificates, malpractice coverage and any other required credentialing documents for all providers
Sets up and maintains provider information in online credentialing databases and system
Tracks license, certification, MCO and professional liability expirations for all providers to ensure timely renewals
Ensures practice addresses are current with health plans, agencies, and other entities
Maintains knowledge of current health plan and agency requirements for credentialing providers
Audits health plan directories for current and accurate provider information
Process and submit claims to multiple payors
Ensure all claims are submitted daily with a goal of zero errors
Timely follow up on insurance claim status
Respond to inquiries by insurance companies
Read and interpret EOB (Explanation of Benefits)
Manage denied claims inventory
Function as back-up for other billing needs and other duties, as necessary
Maintains confidentiality of provider information
Provides credentialing and privileging verifications
Performs other duties as assigned
Qualification
Required
High School diploma or high school equivalent
Proficient use of Microsoft Office applications (Word and Excel) and internet resources
Ability to organize and prioritize work while managing multiple priorities
Excellent verbal and written communication skills including letters, memos, and emails
Ability to research and analyze data
Excellent attention to detail and ability to multitask
Ability to work independently with minimal supervision
Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization
Preferred
Prior medical claim billing experience
Knowledge of medical terminology
Knowledge and understanding of the credentialing process
Experience in CPT and ICD-10 coding
Experience in filing claim appeals with insurance companies to ensure maximum reimbursement
Bilingual (English/Spanish) preferred, but not required
Company
Guidance Center of Lea County, Inc.
Guidance Center of Lea County, Inc. (GCLC) was first established in 1971 as a Crisis Line in a small house in the rural community of Hobbs, New Mexico.
Founded in 1971
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Gloria D. Muñoz
Chief Financial Officer
Company data provided by crunchbase