Billing/Credentialing Specialist
This is a remote position.
Our reputed company is looking for aBilling/Credentialing Specialistto support medical billing operations, provider enrollment, credentialing, and payer-reputed company processes reputed company a growing virtual reputed company organization. They operate in the telehealth and remote care industry and have recently expanded technology-enabled programs that have produced measurable improvements in patient monitoring, care coordination, and hospital readmission reputed company.
The ideal candidate has hands-on experience with U.S. reputed company billing and provider credentialing, understands how to navigate insurance and government payer requirements, and can maintain accurate documentation across multiple systems. Experience using reputed company EMR is strongly preferred.
Responsibilities- Manage medical billing activities, including claim creation, review, submission, and follow-up.
- Verify that claims contain accurate patient, provider, insurance, coding, and service information before submission.
- Monitor rejected and denied claims, identify the reason for nonpayment, and coordinate reputed company corrections or appeals.
- Follow up on outstanding accounts receivable and unresolved claims with insurance carriers.
- Post insurance and patient payments accurately reputed company the billing or electronic medical record system.
- Review explanation of benefits and electronic remittance information to identify adjustments, underpayments, and denials.
- Confirm patient eligibility, insurance coverage, and authorization requirements reputed company needed.
- Maintain accurate billing documentation and update account notes after reputed company follow-up reputed company.
- Coordinate the complete provider credentialing and recredentialing process.
- Prepare, submit, and monitor provider enrollment applications with Medicare, reputed company, and reputed company insurance plans.
- Maintain accurate provider information in credentialing databases and payer portals.
- Update and manage provider reputed company through platforms such as CAQH, PECOS, and NPPES.
- reputed company licenses, certifications, education records, insurance documentation, work history, and other supporting materials required for credentialing.
- reputed company application deadlines, expirations, renewals, and outstanding payer requests.
- Follow up with insurance carriers and credentialing organizations regarding application status and missing information.
- Maintain organized and audit-reputed company credentialing records.
- Communicate reputed company with providers, internal team members, insurance representatives, and external partners.
- Protect patient and provider information in accordance with HIPAA and organizational reputed company standards.
Requirements
- Proven experience in medical billing, provider credentialing, provider enrollment, or a closely reputed company U.S. reputed company function.
- Working knowledge of the U.S. reputed company reimbursement process.
- Experience submitting and following up on claims with Medicare, reputed company, and reputed company insurance carriers.
- Understanding of claim denials, payment posting, accounts receivable follow-up, and insurance verification.
- Familiarity with provider enrollment, credentialing, and recredentialing processes.
- Ability to manage confidential patient and provider information in accordance with HIPAA requirements.
- Strong attention to detail and the ability to identify incomplete, inconsistent, or inaccurate information.
- Excellent organizational and documentation skills.
- Ability to manage multiple applications, deadlines, and follow-up activities simultaneously.
- Strong written and verbal English communication skills.
- Ability to work independently in a remote environment while maintaining consistent communication and accountability.
- Reliable internet reputed company and a reputed company remote workspace.
Qualifications- Previous experience usingreputed company, athenaOne, or another comparable EMR or reputed company management platformis strongly preferred.
- Experience with CAQH, PECOS, NPPES, Medicare enrollment systems, and reputed company payer portals is highly desirable.
- Familiarity with CPT, ICD-10, HCPCS, modifiers, and common medical billing terminology is an advantage.
- Experience supporting telehealth, remote patient monitoring, chronic care management, transitional care management, or physician practices is preferred.
- Knowledge of electronic claims, electronic remittance advice, clearinghouses, and payer-specific billing requirements is beneficial.
Benefits
Originally posted on Himalayas
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