Medical Billing Specialist – Credentialing, Claims Management & RCM Support (U.S. Healthcare)

We are looking for an experienced and detail-oriented Medical Billing & RCM Specialist to handle credentialing, claim submission, payment posting, and denial management for our healthcare clients. You will be responsible for the end-to-end revenue cycle process, ensuring that providers are credentialed correctly, claims are submitted cleanly and on time, and all denials or rejections are resolved promptly. This is a long-term role for a professional who understands U.S. payer systems, HIPAA compliance, and major clearinghouses. Responsibilities: Credentialing & Enrollment: Complete new provider enrollments with Medicare, Medicaid, BCBS, Aetna, Cigna, UHC, and other major payers Maintain and update CAQH profiles Handle revalidation, recredentialing, and insurance panel updates Claims Management Create and submit accurate claims (CMS-1500 / UB-04) Ensure all claims meet payer-specific requirements and HIPAA standards Handle claim rejections, denials, and resubmissions efficiently Perform EOB analysis and payment posting Accounts Receivable (A/R) & Follow-up Track unpaid or denied claims and follow up with payers Identify and resolve root causes of denials Prepare aging reports and maintain updated A/R logs Reporting & Communication Provide weekly claim and payment reports Maintain transparent communication with providers or practice managers Suggest process improvements for faster reimbursement Required Skills & Experience: Minimum 3 years of hands-on experience in U.S. medical billing Strong knowledge of RCM, CPT, ICD-10, and HCPCS coding Experience with credentialing, claim submission, and payer enrollment Proficiency with EHR/EMR systems such as Kareo (Tebra), Office Ally, AdvancedMD, eClinicalWorks, TherapyNotes, or WebPT Familiarity with clearinghouses like Availity, Trizetto, or Change Healthcare Strong English communication skills 100% HIPAA-compliant workflow Please include the following when applying: A short summary of your billing and credentialing experience Software and payers you’ve worked with Example of a challenge you resolved (denial or claim issue) Your availability and preferred working hours Apply tot his job Apply To this Job