Billing and Credentialing Specialist

Position: Billing and Credentialing Specialist

Supervisor: Director of Healthcare Finance

Location: LVD Health Center, Watersmeet, MI

Employment: Full – Non-Exempt

Salary/Pay Rate: $17.00 - $24.00 per hour

POSTING EXPIRATION DATE:
January 5, 2026

UPON HIRE:

PTO

Vision

Health Insurance

DESCRIPTION:

The Lac Vieux Desert Band of Lake Superior Chippewa Indians ("LVD") is seeking a Billing and Credentialing Specialist who will be responsible for maintaining active status for all providers, posting electronic and "paper" payments from third-party payers, government agency payers, and patients in a timely and accurate manner, including following up on billing tasks,inquiries, and documentation.

Including, but not limitedto:

1.Maintain individual provider files to include up todate information needed to complete the required governmental and commercial payer credentialing applications.

2.Maintain internal provider grid to ensure all information is accurate and logins are available.

3.Maintain accurate and up to date provider profiles onCAQH, PECOS, NPPES, and CMS databases.

4.Complete revalidation requests issued by government payers.

5.Complete credentialing, re-credentialing, and privileging applications to add providers to commercial payers, Medicare, and Medicaid.

6.Work closely with the Director of Revenue Cycle and billing staff to identify and resolve any denials or authorization issues.

7.Assist patients with billing inquiries, payments, and account discrepancies.

8.Process all incoming and outgoing billing mail,following up as needed.

9.Post payments, adjustments, and zero-pay EOBs in an accurate and timely manner.

10.Posts patient payments in an accurate and timely mannerto the appropriate line-item charge.

11.Research and resolve "unapplied and/or unidentified" payments to ensure monies are properly distributed.

12.Enter and balance payments assigned by category (Check,Credit Card and/or Electronic Payments) by batch to internal deposit records for the day.

13.Process end-of-day reports (internal deposit slips and clearing of financial queue).

14.Identify collection issues with insurance or patient accounts and communicate to A/R Team.

15.Process and post all insurance recoupments.

16.Employee Safety:
Safely performs all duties; follows required protective protocols to ensure personal safety as well the safety ofothers.

17.Must maintain compliance with ergonomic safety standards; be mindful of posture and regularly practice ergonomic stretches.

18.Employee Safety:
Safely performs all duties; follows required protective protocols to ensure personal safety as well the safety ofothers.

19.Safety:
Responsible for ensuring that all duties,responsibilities, and operations are performed with the utmost regard for thesafety and health of all personnel involved, including themselves.

20.Other duties as assigned by Supervisor.

1.Must have a High School Diploma or GED.

2.Must possess a valid Driver’s License.

3.Ability to communicate professionally.

4.Ability to handle multiple tasks simultaneously.

5.Ability to work autonomously, using discretion as appropriate.

6.Ability to manage and maintain confidential information.

7.Highly proficient in MS Office.

8.General knowledge of finance and accounting functions,policies, practices and terminology.

9.Strong interpersonal skills, including excellent written and verbal communication skills.

12.Strong organizational skills.

13.Demonstrate clear knowledge of LVD Health Center structure, standards, procedures, and protocols.

14.Musthave ability to relate and communicate effectively with community interest groups, agencies, and medical facilities that serve the American Indian Community.