Medical Billing and Credentialing Specialist

Summary

Join Pearl Talent, a recruiting company connecting top candidates with leading startups, as a fully remote Medical Billing and Credentialing Specialist based in the Philippines. This full-time role involves managing billing, credentialing, and compliance processes for a company specializing in mental health services. You will ensure accurate claims submission, payment reconciliation, and maintain provider profiles. The position requires strong organizational skills, attention to detail, and excellent communication. Pearl offers generous benefits including paid time off, health coverage, mentorship, professional development opportunities, and a flexible work schedule.

Requirements

• Minimum of 3-5 years of experience in medical billing, revenue cycle management, or credentialing roles, preferably in healthcare or therapy settings
• Proficiency in medical coding, claims submissions, posting ERAs, and analyzing aging reports
• Experience with credentialing processes, including maintaining CAQH and NPI profiles and ensuring payer compliance
• Familiarity with billing and practice management software, and knowledge of HIPAA compliance standards
• Strong organizational skills, exceptional attention to detail, and the ability to manage multiple tasks efficiently
• Excellent communication skills with a proactive, problem-solving mindset and the ability to work both independently and collaboratively

Responsibilities

• Accurately code medical appointments and procedures to ensure proper claims submission
• Post electronic remittance advices (ERAs) and reconcile payments to maintain accurate financial records
• Analyze aging reports to identify overdue accounts and implement follow-up actions to resolve outstanding payments
• Maintain and update provider profiles in CAQH and NPI registries to ensure accurate credentialing with insurance networks
• Ensure compliance with payer credentialing requirements, including timely submission of renewals and documentation
• Act as a liaison between providers, payers, and leadership to address credentialing or enrollment issues
• Respond to client inquiries regarding billing issues, insurance claims, and payment status
• Collaborate with leadership to streamline billing processes and ensure HIPAA-compliant handling of sensitive client data
• Prepare and maintain detailed financial and credentialing reports for internal review and decision-making

Benefits

• Remote Work: Fully remote—work from anywhere
• Work Schedule: Monday to Friday, 9:00AM - 5:00PM/ 10:00AM - 6:00PM EST
• Generous PTO: Ample paid time off to rest and recharge
• Health Coverage: HMO coverage after 3 months for full-time employees
• Direct Mentorship: Grow through guidance from international industry experts
• Learning & Development: Ongoing access to resources for professional growth
• Global Networking: Work and connect with professionals around the world
• Work-Life Balance: Flexible hours that support a healthy work-life balance