Credentialing Specialist - Leading Industry Pay

We are in need of a brilliant Credentialing Specialist to join our amazing team at Sound in Tukwila, WA.
Growing your career as a Full Time Credentialing Specialist is an incredible opportunity to develop indispensable skills.
If you are strong in critical thinking, people management and have the right drive for the job, then apply for the position of Credentialing Specialist at Sound today!

GENERAL SUMMARY: The Revenue Cycle Specialist who will be responsible for ensuring that client accounts are properly set up with current payor information in a fast-paced, high-volume setting so that payors can be properly billed for all services rendered. This includes, but is not limited to, verifying coverage eligibility for Medicare, Medicaid, and Commercial Insurance for both new and existing clients, entering financial data accurately into the electronic health record (EHR), addressing internal and external customer service inquiries, and assisting in the resolution of billing errors.
ESSENTIAL FUNCTIONS AND DUTIES Data Entry, Management and Reporting Performs a variety of data reporting functions, including processing, batching, uploading, downloading, flagging/unflagging, loading, and unloading. Updates to financial record. Client Benefit Verification, Set Up, Eligibility, and Cancellation Assists with new client financial eligibility setup, updates to existing clients' financial eligibility, and eligibility verifications. Gathers and verifies coverage eligibility for Medicare, Medicaid, and Commercial Insurance for new and existing clients; enters financial data into the electronic health record (EHR). Maintains current and accurate client payor information for the duration of the client's treatment ensuring that proper documentation is obtained. Fields customer service questions, both externally (from clients) and internally (from Sound team members), relating to insurance coverage and benefits. Researches and notifies clinicians of issues such as benefit overlap, pending benefits cancellations/terminations, Assists program supervisors with tracking of benefit approvals and ensures correct setup of financial eligibility. Confirms required documentation is in place, such as signed client release forms Errors, Corrections, and Notifications Resolves errors and discrepancies, which may include missing policy numbers, missing diagnoses, duplicate input, invalid codes, service errors, etc., by researching and reviewing documentation from internal and external data sources. Uses reports to prioritize focus on pending cancellations and missing data. Determines sources of errors and needed corrections, updates, and notifications. Manages needed corrections to services including voiding services with errors and working with clinicians to make corrections to services and notes as needed. Notifies clinicians and supervisors about errors, missing data, legal requirements for documentation in EHR, pending expirations of benefits, and other information, and actions to be taken to resolve. Monitors help desk requests on issues such as benefit authorization requests, other data, and document corrections, and respond via phone, email, or in person. Tracks requests, follows up, and closes tickets appropriately. Administrative Support Creates new user identifications and access to systems; ensures they are appropriately linked to other systems and applications. Sorts and files correspondence. Ensures that audit standards are met with regard to client financial records and assist in annual audit. Collaborates with Finance and Netsmart RCM teams to create and regularly update procedural documentation on all internal processes involving data reporting and work on response files and error reports. SUPPLEMENTAL FUNCTIONS Provides coverage for other team members' work duties as needed for vacation and sick leave. Completes assigned special projects, independently or as a contributor to or lead of a project team. Performs other duties as assigned. KEY WORK RELATIONSHIPS
Establishes and maintains positive, ethical, and professional working relationships with Finance teams, including RCM, clinicians, Sound management and team members, clients, vendors, and other professionals.
EDUCATION AND EXPERIENCE High school diploma or general education degree (GED). At least five (5) years of applicable work experience and computer-related skills. Experience with electronic health record data preferred (Netsmart Avatar preferred). Experience with insurance look-up sites (Provider One and other Commercial payors preferred). KNOWLEDGE, SKILLS, AND ABILITIES Understanding data entry, management, and reporting functions, including querying, reporting, utilities, and web applications. Thorough knowledge of insurance benefit terminology and medical billing concepts. Proficiency with Microsoft applications, including Word, Excel, and Outlook; experience with automated accounting and Electronic Health Record systems (Avatar preferred). Strong ten-key and keyboarding skills. Excellent verbal and written communication and personal interaction skills, with an emphasis on customer service and support; ability to communicate technical information to non-technical persons. Strong analytical, time management, and organizational skills; detail oriented with consistently accurate results. Ability to define problems, collect data, establish facts, and draw valid conclusions, with the ability to provide guidance to others involved in a problem-solving process. Knowledge of HIPAA requirements that pertain to client information and client privacy. Ability to develop and maintain strong professional relationships with team members at all levels, clients, and vendors, and with varying educational, professional and economic backgrounds. Ability to work effectively with minimal supervision, manage multiple duties and priorities, and maintain high standards for accuracy, productivity, and confidentiality. Ability to function as a member of a team, leading within the scope of the position and contributing whenever possible. Must successful pass criminal background checks. PHYSICAL DEMANDS To successfully perform the essential duties of this position, an individual must be able to sit at a desk for four or more hours a day, and use office equipment, including phones and computer keyboards, for four or more hours per day. Individuals must be able to engage vendors, team members, clients and others over the phone and in-person by voice. Regular attendance is an essential function of the position. Reasonable accommodations may be made to assist individuals with disabilities to perform essential position functions.
All Team Members at Sound working 40 hours per week will be eligible for the following benefits: 100% Paid Medical & Dental Insurance Full time Team Member and child(ren) coverage until child's 26th birthday Spouse/Domestic Partner coverage available (team member pays full cost) Paid Life Insurance
2x annual salary + additional $25,000 Long Term Disability Insurance (60% monthly salary)
100% premiums paid by Sound 18 Days of Paid Rest and Relaxation (Vacation) - beginning first year 12 Days of Paid Sick Leave 9 Days of Paid Holidays Health Savings Account (HSA) Flexible Spending Accounts (FSA)
for health care (limited) and dependent day care costs (pre-tax) Employee Assistance Plan (EAP)
The Standard Sound retirement plan:
401(k) plan (organization contribution) – Sound contributes 3% to team members plan even if you don't. Team members are 100% vested; team members may contribute to their own plan Sick Leave Conversion Program - for perfect attendance quarterly Paid Training
Free in-house professional training and $400 annually + 3 paid days off-site training Public Service Loan Forgiveness (PSLF) Free Supervision Hours - Washington State Licensure Service Award - at 5,10,15,20 & 25 years of service Pay Range: $26.35 - 30.89 per hour
Sign-on bonus and pay range listed are for external applicants ONLY. For questions in regards to internal applicants, please reach out directly to the Recruitment Team.

Benefits of working as a Credentialing Specialist in Tukwila, WA:
? Company offers great benefits
? Room for Advancement
? Generous Compensation