Physical Therapy & Sports Medicine Centers

Billing Specialist

• Lead insurance credentialing for PTSMC providers and locations
• Credential all individual clinicians and provide timely updates
• Manage EMR signature rules to facilitate accurate and clean claims submission
• Provide insurance carriers with information needed to re-credential current clinicians and locations
• Maintain CAQH records for current PTSMC clinicians
• Complete applications and learn the credentialing process for participation with new networks
• Initiate temporary permit processes and follow up on status when applicable
• Track license transfers and follow up as needed
• Complete quarterly provider and demographic verifications for participating insurances
• Resolve missing or incorrect provider demographic information with payers
• Filter and submit claims from the In-Review work queue daily
• Correct failed edits, claim rejections, and insurance changes
• Resubmit modified or corrected charges after claim addenda are complete
• Manage self-pay visits by reviewing patient charges and creating remits to close out visits
• Remain current with insurance participation, contract reimbursement, payer guidelines, and policies
• Update insurance information and rebill claims to resolve billing issues
• Monitor billing on hold for new non-credentialed providers
• Review and resolve claims denials related to provider participation
• Keep informed of insurance policy changes through website updates and insurance newsletters
• Assist with coordination and communication of insurance information for accurate billing

Explore Credentialing and Billing Coordinator at Physical Therapy & Sports…. Review requirements and application details.