Accounts Receivable & Credentialing Specialist

Join Our Mission. Lead with Purpose. Make a Difference. Accounts Receivable and Credentialing Specialist OLV Human Services As OLV Human Services continues to grow, so does our commitment to excellenceand that includes expanding our talented finance team. We are currently seeking an Accounts Receivable and Credentialing Specialist who is not only a strategic thinker and experienced financial professional but also shares our passion for fostering the highest possible quality of life for individuals throughout our community. At OLV Human Services, we believe that finance plays a vital role in supporting our mission. The right candidate will align departmental strategies with our agency's values, ensure fiscal accountability, and inspire their team to drive success across the organization. Benefits & Perks Generous Paid Time Off (PTO), including paid holidays Qualifying Non-For-Profit for Federal Student Loan Forgiveness Program Casual dress code Health, dental & vision insurance options Free dental insurance Paid Employer sponsored life insurance. Supplemental insurance programs for additional life insurance, short-term disability, accident & cancer insurance Up to $600 every year for completing biometric health screenings on a single health insurance plan & up to $1,200 if a spouse also completes Up to $180 annual gym reimbursement Take advantage of our Dental & Outpatient Mental Health services while working Employee referral program Pay Range: $27.00 - $31.00/hour Accounts Receivable and Credentialing Specialist Job Summary: The Accounts Receivable & Credentialing Specialist manages the organization's incoming revenue, billing, and the provider enrollment process with insurance payers. Provide proper follow up of denials/aged claims for a diverse collection of services and programs within the agency. Also, maintaining provider credentialing files, and reconciling accounts to ensure steady cash flow. Essential Job Duties: Follow up on aged denials, working with payer representatives as needed for resolution. File any necessary appeals with insurance payers to ensure payment of claims Assist the team with resolving complex billing issues. Resolve any billing discrepancies and maintain accurate financial records. Perform periodic audits of claims, especially with new providers, communicate findings and educate staff to improve. Ensure adherence to federal/state regulations Maintain patient confidentiality Run and reconcile monthly reports Identify and communicate trends and patterns in billing, adjustments, and payments Manage the enrollment process for healthcare providers with insurance carriers Verify, maintain, and update provider licenses/certifications and CAQH profiles Ensures all new providers are credentialed with payers timely, with regular follow-up Any other duty as assigned by your supervisor Skills: Proficiency in billing claims and using billing software Proficiency with Microsoft 365 (Excel, Word, Outlook, Teams) Attention to detail, high accuracy with data entry and review Strong, oral, written, and communication skills. Ability to work effectively with payors and their representatives Problem solving Confidentiality Minimum Education & Experience Required: Associate's degree in related field plus 5 years' experience with billing and credentialing OR Bachelor's degree in related field plus 2 years' experience with billing and credentialing License/Registration/Certifications Required: Certified Professional Coder (CPC) preferred Training Requirements: New Hire Orientation Physical Requirements: The overall nature of the position is sedentary, requiring little physical effort with occasional light physical exertion required. There is little, if there is any, exposure to environmental conditions The constant physical demand of the position is sitting. The frequent physical demands of the position are standing, walking, climbing, talking, hearing, repetitive motions, and eye/hand/foot coordination. The occasional physical demands of the position are lifting, carrying, pushing, pulling, balancing, stooping, crouching, reaching, handling, grasping, and feeling.

Created: 2026-03-04