55 medical staff credentialing compliance specialist jobs found

Henry Ford Health System in Jackson, Michigan is seeking a Credentialing Specialist for the Medical Staff Affairs department. This full-time position involves supporting credentialing processes, managing medical staff meetings, and ensuring compliance with various accrediting bodies. The ideal candidate will have strong organizational skills, experience in a medical setting, and a high school diploma or equivalent, with an associate's degree preferred. The role offers an opportunity to contribute to a mission-driven organization focused on excellence in patient care and provider support. #J-18808-Ljbffr

Exalt Health is hiring a Medical Staff Credentialing Coordinator to support the Compliance team by managing the credentialing process for healthcare providers. The role includes verifying credentials, maintaining accurate provider data, and ensuring adherence to regulatory standards. The ideal candidate should have a High School Diploma, 2 years of experience in hospital credentialing, and strong skills in Microsoft Office. This position requires attention to detail and the ability to work independently. #J-18808-Ljbffr

UF Health in Jacksonville, Florida, is looking for a dedicated professional for a Full-Time Onsite position focusing on credentialing and audits. This role requires strong knowledge of NCQA standards and involves preparing policies, as well as handling hospital credentialing for non-board approved providers. The ideal candidate will have a Bachelor's Degree and at least 10 years of relevant experience or equivalent certifications. Skills in database applications, excellent communication, and the ability to work across various departments are essential for success in this position. #J-18808-Ljbffr

Direct Jobs is seeking a Credentialing Coordinator responsible for overseeing the credentialing and re-credentialing process. This role includes auditing and managing application workflows, ensuring compliance with our policies, and preparing reports for governance. The ideal candidate has an H.S. Diploma/GED and 3 years of relevant experience. Certifications in credentialing are preferred. Join us to support and enhance the medical staff services department. #J-18808-Ljbffr

Exalt Health Opco LLC in Garland, Texas, is seeking a Medical Staff Credentialing Coordinator to support the Compliance team. This role involves the meticulous management of enrollment, credentialing, and re-credentialing documentation for healthcare providers to ensure their compliance with regulations. The ideal candidate will have a High School Diploma, 2 years of pertinent experience, and excellent attention to detail. Responsibilities include managing data, verifying provider credentials, and tracking documentation expiration. #J-18808-Ljbffr

Frederick Health in Frederick, Maryland is seeking an experienced individual to manage medical staff office functions, ensuring compliance and efficiency. You will oversee onboarding, maintain provider compliance, and support various administrative tasks within the medical staff office. The ideal candidate will possess strong organizational skills, basic medical terminology knowledge, and advanced proficiency in MS Office applications. A high school diploma and two years of relevant experience are mandatory. This role offers a competitive hourly pay range of $22.27 - $31.28, with a flexible Monday to Friday schedule, totaling 36 hours per week. #J-18808-Ljbffr

Job Description Job Description ORGANIZATION INFORMATION: Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives. Hourly Range: $23.5577 to $32.9808 USD POSITION SUMMARY: The Medical Billing Specialist reports to the Revenue Cycle Manager and is responsible for various tasks to ensure efficient billing, follow up, payment processing, and patient communication activities to...

Job Description Job Description Medical Billing Specialist About Us At Atlas Medical, we're expanding our team and are seeking a dynamic and compassionate Medical Billing & Insurance Specialist who shares our passion for making healthcare better for all. If you're someone who values meaningful work, thrives in a supportive environment, and believes in enriching the lives of those you encounter, this may be the perfect opportunity for you. Location: Omaha, NE Compensation: $22 / Hour DOE Status: Full-Time, W2 Employee Schedule: Monday - Friday, 8 AM - 5 PM Job Summary The Medical Billing Specialist is responsible for managing the medical claims process from submission through payment resolution to ensure accurate and timely reimbursement. This role includes submitting and reviewing insurance claims, processing electronic remittance advices (ERAs), posting insurance payments, and verifying patients' insurance eligibility and benefits. The specialist investigates...

Job Description Job Description ORGANIZATION INFORMATION: Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives. Hourly Range: $23.5577 to $32.9808 USD POSITION SUMMARY: The Medical Billing Specialist reports to the Revenue Cycle Manager and is responsible for various tasks to ensure efficient billing, follow up, payment processing, and patient communication activities to...

Medical Biller & Revenue Cycle Manager Benefits: Dental insurance, employee discounts, health insurance, paid time off, vision insurance Location: Brentwood, CA Work Arrangement: In person Employment Type: Full time, exempt Schedule: Monday through Friday, business hours Compensation: $71,000 to $75,000 annually, depending on experience and qualifications Bonus Eligibility: Eligible for quarterly performance incentives based on measurable revenue cycle goals Key Responsibilities Review and submit claims daily for accuracy, timeliness, and payer compliance. Monitor accounts receivable and follow up on outstanding claims, denials, underpayments, and billing delays. Partner with outsourced billing vendors to support timely and accurate billing processes. Track missing or incomplete documentation, service logs, and timesheets that may impact billing. Support credentialing and payer enrollment tracking for commercial insurance, Medicare, Medicaid/Medi-Cal, Regional...

Job Description Job Description Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California. Qualifications: · The successful candidate must have an excellent understanding of medical billing, which includes Insurance billing and payments processing: EOBs, ICD-10 and CPT coding. · Candidates must have a strong understanding and working knowledge of the appeals and denials processes for Medicare, Medi-Cal and other commercial health insurances. · Candidate is going to ensure all compliance and quality requirements are met. · Candidate can efficiently communicate insurance company, clinical staffs and patients regarding billing issues. · In addition, this position is the main link between our facility and our referring clients. In this role, you will maintain a solid rapport with all our clients...

Job Description PLEASE BE ADVISED that this position is covered by the collective bargaining agreement between Cook County and the AFSCM Union. Pursuant to the collective bargaining agreement, Cook County will exhaust internal eligible applicants prior to considering external applicants. Cook County is assembling a list of qualified candidates for this position that will be considered should the position not be filled with internal eligible applicants. LOCATION: John H. Stroger, Jr. Hospital DEPARTMENT: Health Information Management SHIFT: 7:00 AM - 3:00 PM PAYRANGE: $37.658 HOURLY JOB SUMMARY Under the supervision of a Coding Supervisor, the Health Information Management (HIM) Coder abstracts relevant clinical and demographic information from the medical record to identify the care rendered to the patient for the purpose of reimbursement, research and compliance. The HIM Coder ensures that the medical record reflects accurate attending physician documentation for coding of...

Established in 1984, Equitas Health is a regional not‑for‑profit community‑based healthcare system and federally qualified community health center look‑alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives. Hourly Range $23.5577 to $32.9808 USD POSITION SUMMARY The Medical Billing Specialist reports to the Revenue Cycle Manager and is responsible for various tasks to ensure efficient billing, follow‑up, payment processing, and patient communication activities to maximize revenue. ESSENTIAL JOB FUNCTIONS Essential functions of...

Senior Coding Compliance Auditor and Educator Join to apply for the Senior Coding Compliance Auditor and Educator role at Tryon Medical Partners Senior Coding Compliance Auditor and Educator 3 days ago Be among the first 25 applicants Join to apply for the Senior Coding Compliance Auditor and Educator role at Tryon Medical Partners Get AI-powered advice on this job and more exclusive features. General Job Summary : The Senior Coding Compliance Auditor and Educator will be responsible for auditing outpatient professional services documentation ensuring compliance with coding and billing guidelines, identifying areas for improvement, and providing training to clinicians and coders to support accuracy, compliance, and adherence to industry standards. This role involves both auditing medical records and educating coders, providers, and staff on professional coding guidelines and best practices. (this is a full-time position that will support our Compliance team, Monday to Friday 8 am...

Medical Coding Specialist - Profee Surgery Coder Company Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional...

Position: RCM Revenue Integrity Specialist - Coder Certified Location: Remote Remote Status: Remote Job Id: 900 # of Openings: 3 Company Description Unio Health Partners (UHP) is a highly differentiated physician practice management platform with the goal of transforming care delivery across the Western United States. UHP partners with leading physician practices, creating a cohesive, quality-oriented clinical culture and facilitating best practice sharing across the platform. Our affiliated practices gain access to a broader suite of services, providing a meaningful benefit to both physicians and patients. UHP's best-in-class clinical program covers three sub-specialties (urology, gastroenterology, and radiation oncology) and offers numerous ancillary services, including pathology lab, in-office dispensing, and chronic care management. We are led by a highly accomplished management team and provide a full suite of management services to its affiliated practices. UHP is...

Medical Billing Specialist At Exceptional Wellness Counseling (EWC), we're not just a mental health group practice - we're a community. Therapist-owned and people-first, we believe your job should support your well-being, not deplete it. We foster a collaborative, supportive, and growth-oriented culture where hard work is valued, kindness matters, teamwork is essential, and people are encouraged to bring their spark every day. We believe the best work happens when people feel supported, connected, and empowered to grow. We're looking for a Medical Billing Specialist to support our billing department and help ensure a positive, efficient financial experience for our clients. This role is ideal for someone who is organized, dependable, eager to learn, and excited to grow within a supportive and collaborative team environment. What You'll Be Doing: Support a solution-focused and collaborative billing environment, Support the billing cycle including claim submission,...

Reports to the Manager, Coding & Records. Reviews, codes, and analyzes medical records in order to abstract relevant data from patient medical records into the on-line computer system. Assigns DRGs to Medicare, Medicaid, and other required payors. Determines DRG and APC assignment on outpatient and inpatient records. Maintains productivity and accuracy levels for the assigned job code. MISSION, VALUES and SERVICE GOALS MISSION: We deliver outstanding care, inspire health, and connect with heart. VALUES: Trust. Respect. Integrity. Compassion. SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team. Reviews and analyzes discharged patient medical records to ensure all applicable patient data is available for coding and abstracting by: Checking the diagnosis and procedure to ensure accurate coding and sequencing as specified by established coding principles and guidelines, following AHA, AHIMA, and CMS coding guidelines for outpatient...

Job Summary Under limited supervision, the Credentialing Supervisor oversees system-wide credentialing and privileging operations across all Vandalia Health North hospitals (7-9 facilities). This role supervises a team of Credentialing Specialists, ensuring that credentialing, recredentialing, and privileging functions are timely, accurate, and compliant with all regulatory and accreditation standards. The Supervisor partners with the Senior Director of Medical Affairs, hospital leadership, and medical staff committees to maintain operational excellence, data integrity, and continuous improvement within the Medical Staff Office. The Credentialing Supervisor serves as the primary interface with hospital and system business owners for credentialing, privileging, and compliance-related initiatives. This position also functions as the MD-Staff super-user for Vandalia Health North, supporting system configuration, troubleshooting, training, and reporting. The Supervisor leads all...

Medical Billing Specialist The Medical Billing Specialist is responsible for managing the billing and payment activities of multiple programs, clients and/or 3rd party payee accounts and will serve as a point of contact for primarily for clients, at times for internal staff regarding billing-related matters, and occasionally deals with third-party payers. The role can include seasonal special projects. JFCS is a multi-faceted human services agency with the mission to provide essential services to people of all ages and backgrounds to sustain healthy relationships, ease suffering and offer support in times of need. JFCS is a place where you can put your values to work every day. You will be able to: Make a positive difference in the lives of others Feel energized to give your best effort and enjoy a healthy work/life balance Learn, grow and accomplish new things JFCS serves and employs people of all cultures and faith traditions and highly values inclusion and diversity. All...

Summary The Medical Billing Specialist is responsible for managing the billing and payment activities of multiple programs, clients and/or 3rd party payee accounts and will serve as a point of contact for primarily for clients, at times for internal staff regarding billing-related matters, and occasionally deals with third-party payers. The role can include seasonal special projects. EEO Statement JFCS serves and employs people of all cultures and faith traditions and highly values inclusion and diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. AA/EEO Benefits Work-life balance including vacation, wellness leave (sick time), paid family and medical leave, holidays, flexible schedule, and a hybrid working schedule with the ability to work from home up to 60% of the time. Competitive benefits package...

Overview Reports to the Manager, Coding & Records. Reviews, codes, and analyzes medical records to abstract relevant data into the on-line computer system and assigns DRGs to Medicare, Medicaid, and other required payors. Determines DRG and APC assignment on outpatient and inpatient records. Maintains productivity and accuracy levels for the assigned job code. Responsibilities Review and analyze discharged patient medical records to ensure all applicable data is available for coding and abstracting, following established coding principles and guidelines (AHA, AHIMA, CMS) for outpatient and inpatient records. Obtain accurate and complete patient data through review of the medical record, discharge summary, history and physical, consultation, progress notes, laboratory, radiology, operative and pathology reports. Code all procedures on inpatient records (all payors) and outpatient surgical records according to ICD-9-CM Codes, CPT-4 or Physician E&M levels (as applicable)....

Job Summary The Coder I position is responsible for accurate coding, abstracting, claims filing, documentation review, and claims denial processing working from the appropriate documentation in the medical record. The coder must stay up to date on code changes and coding guidelines to assure quality and code compliance is met at all times. The coder also has additional combined responsibilities of data quality and insurance representative functions working closely with other members of the HIMS department. Essential Job Responsibilities Reviews inpatient and outpatient medical records to identify the principal diagnosis and all applicable secondary diagnoses and procedures. Uses the computerized encoding system to facilitate accurate coding according to the appropriate classification system. Sequences diagnoses and procedures by following ICD‑10‑CM, ICD‑10‑PCS, CPT/HCPCS, UHDDS, Medicare, Medicaid, and other fiscal intermediary guidelines. Will be cross‑trained to assist with...

Supervisor Medical Staff Services - Credentialing, $5000 Sign on Bonus! Leads, plans, organizes and is responsible for the day-to-day operations of the Medical Staff Services Department so that all aspects of the Organized Medical Staff are supported, including credentialing activities, professional relations, meeting management, and peer review activities. Additionally, compliance is maintained, with accrediting and regulatory agencies as related to the Medical Staff, including (but not limited to) Joint Commission, DNV, HFAP, CMS, OSHA, and State and Federal Law and other standards and regulations. Licensure, Registration, and/or Certification Preferred: Credentialing Specialist, Certified Provider (CPCS) issued by the National Association Medical Staff Services (NAMSS), or Medical Services Management, Certified Professional (CPMSM) issued by the National Association Medical Staff Services (NAMSS). If not certified, expectation is to certify within 3 years of employment...