Medical Billing

1 week ago

Orlando, Florida, United States Optimum CV, PLLC Full time

A US company is hiring a dedicated and experienced Medical Billing & Credentialing Specialist to manage payer enrollment, insurance credentialing, and medical billing processes for our providers and clients. This is a remote position with opportunities to grow as our team expands.

Primary Responsibilities

Credentialing

  • Maintain provider records in CAQH, PECOS, NPPES, and payer portals.

  • Complete Medicare/Medicaid/commercial credentialing applications.

  • Track payer enrollment status, EFT/ERA setups, revalidations, and expirations.

  • Communicate with payers and providers to resolve credentialing issues.

Billing

  • Submit electronic claims through EHR or clearinghouse.

  • Post payments (ERA/EOB), correct denials, and initiate appeals as needed.

  • Follow up on unpaid or underpaid claims.

  • Conduct basic audits to verify code accuracy and clean claim status.

  • Following up on unpaid balances.

  • Responding to patient billing questions via email or phone.

  • Insurance Benefit Verification

  • Document copays, deductibles, and plan exclusions

  • Prior Authorization Support

  • Complete and track PA forms for services

  • Follow up on status and escalate if delays occur

  • Patient Invoicing & Statement Follow-up

  • Track overdue balances and send reminders

  • Flag underpayments or discrepancies for correction

  • Claims Audits & Error Resolution

  • Monitor rejections/denials

  • Run pre-submission checks for CPT/code accuracy

  • Recommend coding changes or resubmissions

Requirements

  • 2+ years' experience in U.S. healthcare credentialing and/or medical billing.

  • Knowledge of payer processes for Medicare, Medicaid, and commercial plans.

  • Excellent written English and ability to follow up persistently and professionally.

  • Highly organized and detail-oriented.

  • Quiet work environment and reliable internet connection.

  • Available for 40 hours/week during U.S. business hours (some flexibility allowed).

Note: You may occasionally be asked to assist with related admin tasks during slower billing/credentialing periods.

Compensation

  • Depends on experience

Fillout the form:

Job Types: Full-time, Part-time

Pay: From $22.00 per hour

Expected hours: No more than 40 per week

Benefits:

  • Professional development assistance

Work Location: In person

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