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Billing Configuration Specialist

Company: Credible
Location: Rockville
Posted on: June 6, 2021

Job Description:

Qualifacts and Credible, two leading providers of Electronic Health Records (EHR) and related technology to behavioral health and human services agencies, merged in August 2020. The new entity combines and brings to market the decades of experience each company achieved individually, and is laser-focused on helping agency partners improve clinical outcomes, enhance operations, and create healthier communities. The company is offering, enhancing, and fully supporting both EHR platforms - CareLogic and Credible - while collaborating to build an even brighter future for partner agencies and their clients.

If you are interested in combining a mission driven position with a fast paced, results oriented culture, please apply today!

Duties and Responsibilities for the Billing Configuration Specialist

  • Work collaboratively with Billing Specialists to determine billing configuration inconsistencies and completion.
  • Work collaboratively with Billing Specialists to improve quality of billing configuration procedures and documentation.
  • Audit implementation projects to ensure compliance with documentation standards.
  • Audit implementation projects to ensure configuration is accurate with the data provided by the Partner.
  • Audit implementation projects to ensure configuration meets with Payer and State regulations.
  • Work collaboratively with the National Billing Manager to improve internal processes and increase checks and balances to decrease risk of configuration errors.
  • Understand how to read and interpret EDI files.
  • Understand and consistently apply Credible's Best Practice workflows for pre-billing, batching, and posting.
  • Understand and consistently apply Credible's Best Practices for billing configuration and testing.
  • Maintains confidentiality; adheres to all HIPAA guidelines/regulations
  • Other Duties as assigned by Supervisor.
  • Learn and develop a thorough understanding of Credible software.
  • Complete Credible New Employee Orientation program.
  • Completion of Credible's product knowledge and training.
  • 50-75% Travel required.
  • Clear understanding of Credible's:
  • Culture
  • Corporate structure
  • Lines of business

  • Additional duties as assigned.

Experience for the Billing Configuration Specialist

  • Previous medical billing experience along with knowledge of billing related reporting; 3 - 5 years' experience in Behavioral health-care billing & collection practices.
  • Experience in Quality Review/Auditing of EHR configuration.
  • Experience working with medical payers such as Medicare, Medicaid, commercial insurances.
  • Working knowledge of medical billing systems/softwares.
  • Experience with Medicaid's State Eligibility Systems (various states).
  • Working knowledge of CPT and ICD-9/ICD-10 coding systems; Coding certification preferred.
  • BA/BS preferred.
  • Excellent organizational skills.
  • Proficiency in Microsoft Office Suite.


Qualifacts+Credible is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law.

Keywords: Credible, Rockville , Billing Configuration Specialist, Other , Rockville, Maryland

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