Reporting to the Revenue Cycle Manager, the billing and credentialing analyst provides support to the billing, insurance verification and authorization team (50%) and manages all aspects of the provider credentialing process (50%).
As part of the revenue cycle team, the incumbent will perform insurance verification, authorization and denial review and resolution and provide cross coverage in these areas. Candidate will act as a liaison between the department of Neurology and the FPO Provider Enrollment Group (PEG) and will coordinate with Neurology HR and Faculty Affairs office to successfully onboard new providers. The credentialing coordinator will organize, maintain, and verify all aspects of the process, and maintain current files on practitioners. He/she will track the expiration of certifications to maintain up to date files and assist health plan providers and customers with phone inquiries.
Credentialing Coordinator Responsibilities:
Provides cross coverage assistance when need to billing, insurance verification and authorization teams
Aims to reduce accounts receivable by reviewing claims rejected for eligibility and other non-clinical reasons?? investigates assigned accounts to determine what additional steps must be taken for claims to be resolved.
Collects and prepares payor documentation to assist with complex denials
Participates in department and CUIMC revenue cycle improvement projects and training.
Runs standard reports and provides root cause analysis on issues impacting the revenue cycle.
Answers and triages patient correspondence received via telephone and email and. Responds to inquiries and directs callers.
Processes initial credentialing and re-credentialing applications.
Performs routine provider enrollment tasks for onboarding providers and tracks outcomes.
Performs routine provider enrollment maintenance tasks, including annual Medicaid ETIN enrollment, and tracks outcomes.
Maintains individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications. Identifies discrepancies in information and conducts follow-ups.
Maintains current status for state licensure, DEA registration, certifications, and professional liability insurance by tracking expirables on a concurrent basis. Collects and tracks health documents, training certificates and educational modules as required
Participates in special provider enrollment projects as needed.
Presents applications to the FPO Enrollment Group
Assists customers with credentialing inquiries. Responds to health plan provider inquiries.
Maintains and updates the provider participation grid to be used by call center and practices
Attends quarterly PEG credentialing meetings
Assists billing office with other projects
Other duties and projects as required.
Bachelor???s Degree or the equivalent in education, training and experience plus a minimum of three years of relevant administrative experience. Strong organizational and communication skills necessary, MS Word, Excel and Outlook proficient.
Preferred candidates will be reliable, energetic, and have excellent people skills.
Knowledge of electronic medical records and billing systems. EPIC experience preferred.
Must successfully complete system training requirements.
Must have an active NY notary public license or be willing to become a NY notary public within 6 months of hire date.
Excellent interpersonal skills, oral and written communication skills; ability to prioritize with multiple assignments
Demonstrate strong verbal and written communication skills
Ability to exercise excellent judgment and diplomacy in all interactions.
Customer service skills
Must be detail oriented and have excellent organizational skills
Must be proficient in the use of Microsoft Office suite, including Excel and PowerPoint.
Must use sound judgment in prioritizing work, and possess a professional sense of accountability.
Must demonstrate proven ability to interact with all levels of faculty and staff.
Ability to learn new applications to function effectively in a remote work environment.
Equal Opportunity Employer / Disability / Veteran
Columbia University is committed to the hiring of qualified local residents.
Columbia University is one of the world's most important centers of research and at the same time a distinctive and distinguished learning environment for undergraduates and graduate students in many scholarly and professional fields. The University recognizes the importance of its location in New York City and seeks to link its research and teaching to the vast resources of a great metropolis. It seeks to attract a diverse and international faculty and student body, to support research and teaching on global issues, and to create academic relationships with many countries and regions. It expects all areas of the university to advance knowledge and learning at the highest level and to convey the products of its efforts to the world.