Remote Medical Credentialing & Billing Specialist

Jobgether SRL; Ireland; Remote; EUR 42.000 - 64.000; Vollzeit

Benefits dieser Stelle

Fully remote work arrangement

Full-time employment

Standard Monday-to-Friday business hrs

Zusammenfassung

Jobgether SRL is seeking a Medical Insurance Credentialing Specialist based in Ireland for a fully remote role. You will handle provider enrollment, credentialing, and claims processing while ensuring compliance and timely reimbursements.

You will collaborate with payers and internal teams, maintain records, and improve revenue cycle processes in a compliant, efficient healthcare environment.

Qualifikationen

• 2+ years of experience in medical credentialing, medical billing, or both.
• Strong knowledge of commercial insurance, Medicare, Medicaid and managed care.
• Familiarity with payer portals and EHR/billing software.
• Certification in medical billing/coding is a plus.

Aufgaben

• Prepare and submit credentialing applications for new providers across commercial carriers, Medicare, Medicaid, and managed care.
• Manage provider re-credentialing within required timelines to prevent lapses.
• Maintain provider information in credentialing databases and payer portals.
• Coordinate with providers to collect licenses, certifications, and signatures.
• Review and submit medical insurance claims using EHR and billing systems.
• Apply CPT, ICD-10, HCPCS codes including modifiers per guidelines.
• Verify demographics, eligibility, and coverage before submitting claims.
• Monitor claims status, handle edits/rejections, and coordinate adjustments.
• Post payments and write-offs; identify underpayments and discrepancies.
• Reconcile payment reports and maintain billing records.
• Investigate denials and prepare timely appeals.
• Maintain follow-up logs and ensure deadlines are met.
• Ensure HIPAA/CMS/compliance with payer policies and regulations.
• Collaborate with teams to resolve billing and credentialing issues.
• Serve as liaison between providers and payers to resolve enrollment issues.
• Keep up with payer changes and coding guidelines.
• Audit credentialing files and report progress/compliance status.
• Identify recurring payer issues and suggest process improvements.

Kenntnisse

Attention to detail

Organizational skills

Time management

Problem solving

Excellent communication

Ausbildung

Associate or Bachelor's degree in healthcare administration, business, or related field

Tools

CAQH ProView

NPPES

PECOS

Availity

EHR software

Jobbeschreibung

Jobgether SRL is seeking a Medical Insurance Credentialing Specialist based in Ireland for a fully remote role. You will handle provider enrollment, credentialing, and claims processing while ensuring compliance and timely reimbursements.

You will collaborate with payers and internal teams, maintain records, and improve revenue cycle processes in a compliant, efficient healthcare environment.