Medical Billing Specialist

Position Summary:
We are seeking an experienced Insurance Specialist with expertise in medical billing, insurance claims processing, rejections management, and provider credentialing. The ideal candidate must be detail-oriented, organized, and knowledgeable in navigating payer requirements to ensure timely and accurate reimbursements and credentialing for healthcare providers.

Key Responsibilities:

• Submit accurate insurance claims (electronic and paper) to commercial, Medicaid, and Medicare payers.
• Review and resolve claim rejections, denials, and underpayments promptly.
• Perform insurance follow-ups to ensure timely reimbursement.
• Maintain up-to-date knowledge of payer guidelines and CPT/ICD-10 codes.
• Complete and manage provider credentialing and recredentialing applications for multiple payers.
• Track application statuses and follow up with insurance companies to ensure timely approvals.
• Update and maintain accurate records of contracts, credentialing statuses, and CAQH profiles.
• Collaborate with providers, billing vendors, and internal staff to ensure credentialing and billing compliance.
• Assist with patient billing inquiries and verify insurance eligibility as needed.

Qualifications:

• Minimum 2 years of experience in medical billing and credentialing.
• Strong understanding of insurance claims, billing procedures, EOBs, and denial codes.
• Experience with payer portals, CAQH, Availity, PECOS, and other credentialing platforms.
• Familiarity with EHR/EMR and billing systems (e.g., Kareo, Tebra, Charm, AdvancedMD, etc.).
• Excellent communication and follow-up skills.
• High attention to detail and strong organizational abilities.

Preferred Qualifications:

• Experience with multi-specialty or telehealth practices
• Working knowledge of insurance contracts and fee schedules

Job Type: Part-time

Pay: From Php140.00 per hour

Expected hours: 5 – 10 per week

Benefits:

• Flexible schedule
• Work from home

Experience:

• CAQH: 2 years (Required)
• PECOS: 2 years (Required)
• Availity: 2 years (Required)

Work Location: Remote

Expected Start Date: 06/09/2025