Billing/Credentialing Specialist

This is a remote position. Our client is looking for a Billing/Credentialing Specialist to support medical billing operations, provider enrollment, credentialing, and payer-related processes within a growing virtual healthcare organization. They operate in the telehealth and remote care industry and have recently expanded technology-enabled programs that have produced measurable improvements in patient monitoring, care coordination, and hospital readmission outcomes. The ideal candidate has hands-on experience with U.S. healthcare billing and provider credentialing, understands how to navigate insurance and government payer requirements, and can maintain accurate documentation across multiple systems. Experience using Athenahealth EMR is strongly preferred. Responsibilities Manage medical billing activities, including claim creation, review, submission, and follow-up. Verify that claims contain accurate patient, provider, insurance, coding, and service information before submission. Monitor rejected and denied claims, identify the reason for nonpayment, and coordinate timely corrections or appeals. Follow up on outstanding accounts receivable and unresolved claims with insurance carriers. Post insurance and patient payments accurately within the billing or electronic medical record system. Review explanation of benefits and electronic remittance information to identify adjustments, underpayments, and denials. Confirm patient eligibility, insurance coverage, and authorization requirements when needed. Maintain accurate billing documentation and update account notes after each follow-up action. Coordinate the complete provider credentialing and recredentialing process. Prepare, submit, and monitor provider enrollment applications with Medicare, Medicaid, and commercial insurance plans. Maintain accurate provider information in credentialing databases and payer portals. Update and manage provider profiles through platforms such as CAQH, PECOS, and NPPES. Gather license