Our client, a growing healthcare practice, is seeking an experienced Medical Billing & Credentialing Specialist to support its financial and administrative operations. This role is ideal for a detail-oriented healthcare professional with strong experience in medical billing, Revenue Cycle Management (RCM), Accounts Receivable (AR), and provider credentialing.
The ideal candidate is self-motivated, organized, and able to work independently while managing billing processes, resolving claim issues, and maintaining provider credentialing within Athena.
Key Responsibilities
- Manage the full medical billing and Revenue Cycle Management (RCM) process.
- Monitor and follow up on aging Accounts Receivable (AR) and outstanding claims.
- Investigate and resolve claim denials, payment discrepancies, and reimbursement issues.
- Verify patient insurance eligibility and benefits.
- Complete provider credentialing and recredentialing processes.
- Maintain accurate billing, credentialing, and provider records within Athena.
- Communicate with insurance companies regarding claims, credentialing, enrollments, and payment issues.
- Maintain accurate documentation within the practice management system.
- Support additional healthcare administrative tasks as needed.
- Ensure compliance with HIPAA regulations and medical billing best practices.
Required Qualifications
- Minimum 3 years of experience in medical billing, Accounts Receivable (AR), and provider credentialing.
- Strong understanding of the complete Revenue Cycle Management (RCM) process.
- Hands-on experience using Athena.
- Proven experience resolving denied claims and managing aging AR.
- Excellent verbal and written English communication skills.
- Ability to work independently with minimal supervision.
- Strong organizational, analytical, and time-management skills.
- High level of accuracy and attention to detail.
Preferred Qualifications
- Experience supporting multiple medical specialties.
- Knowledge of Medicare, Medicaid, and commercial insurance plans.
- Experience with provider enrollment and payer credentialing.
- Comfortable working remotely in a fast-paced healthcare environment.
We're Looking For Someone Who Is
- Self-driven, proactive, and highly accountable.
- Organized with excellent problem-solving skills.
- Detail-oriented and committed to accuracy.
- Able to prioritize competing tasks effectively.
- Results-oriented with a strong sense of ownership.
- Comfortable working independently while consistently meeting deadlines.
Work Schedule
- Part-Time initially, with the opportunity to transition into a Full-Time role based on business needs.
- Schedule aligned with the U.S. Eastern Time (ET) zone.
Technical Requirements
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Reliable computer or laptop capable of supporting healthcare software.
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Stable high-speed internet connection.
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Professional headset with microphone.
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Quiet, distraction-free home office.
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Fully remote position.
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Opportunity to grow into a full-time role with a growing healthcare practice.
Originally posted on Himalayas
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