We are looking for a detail-oriented and experienced Full Cycle Medical Biller with Credentialing Experience to handle comprehensive medical billing tasks while also managing provider credentialing nationwide. This role supports timely reimbursements and ensures provider compliance with all payer and regulatory requirements.
Key Responsibilities:
- Handle full-cycle medical billing: insurance verification, coding, charge entry, claim submission, denial management, payment posting, and collections.
- Assign CPT and ICD-10 codes based on provided documentation and practice-specific guidelines; conduct basic code research as needed.
- Manage nationwide provider credentialing and re-credentialing processes, ensuring compliance with NCQA, CMS, and payer-specific standards.
- Verify provider credentials, including licensure, education, board certifications, and malpractice history, and maintain updated records across systems.
- Submit and track payer applications and proactively manage expirations for licenses, DEA registrations, and insurance policies.
- Coordinate with internal teams to meet telehealth, hormone therapy, and controlled substance prescribing requirements.
- Communicate with providers and internal stakeholders to gather documentation, resolve discrepancies, and support timely onboarding.
Requirements
- 2+ years of healthcare billing experience
- Experience handling of the entire billing cycle
- 1+ year of provider credentialing and payer enrollment
- Familiarity with NCQA, CMS, and payer credentialing standards
- Strong attention to detail and organizational skills
- Excellent written and verbal communication
- Able to work independently in a remote, fast-paced setting
- Willingness to work in US time zones (PST, EST, CST).
- High school diploma or equivalent.
System and Work Setup Requirements:
- Internet: Minimum speed of 25 Mbps or higher, with a reliable backup connection available in case of power outages or service provider issues.
- Processor: Intel Core i5 7th Generation or higher (or equivalent).
- Memory: 8 GB RAM.
- Storage: 256 GB SSD or HDD with at least 50% free space available.
- Webcam: 720p resolution or higher.
- Operating System: Windows 10 or later (or equivalent).
- Audio Equipment: Noise-canceling earphones or headset.
- Workspace: A designated, quiet, and organized workspace free from distractions to ensure productivity and focus.
Benefits
- Permanent remote work setup
- Competitive starting rate paid in USD
- Internet Allowance
- HMO insurance (PH)
- Retirement Fund
- Paid US holidays
- Paid Vacation and Sick Leaves
Originally posted on Himalayas
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