Remote Medical Credentialing & Billing Specialist

Jobgether SRL; Portugal; Remote; EUR 28,000 - 42,000; Full time

Benefits offered by this job

Fully remote work arrangement

Full-time employment

Standard hours

Career development in credentialing/bh

Collaborative healthcare team

Job summary

Jobgether SRL is seeking a Medical Insurance Credentialing Specialist based in Portugal. The role focuses on provider credentialing, enrollment, and claims management in a remote healthcare environment, coordinating with payers, providers, and internal teams to ensure compliant, timely reimbursement.

Responsibilities include preparing credentialing applications, managing re-credentialing, data accuracy across systems, and resolving denials while ensuring payer policies and deadlines are met.

Qualifications

• High school diploma or equivalent; associate or bachelor preferred.
• 2+ years in medical credentialing, billing, or both with multiple payers.
• Knowledge of commercial, Medicare, Medicaid, and managed care processes.
• Familiar with CAQH ProView, NPPES, PECOS, Availity, payer portals, EHR or billing software.
• Experience preparing claims, resolving denials, and ensuring payer compliance.
• Understanding CPT, ICD-10, HCPCS coding and modifiers.
• Ability to work remotely with strong documentation and follow-up discipline.

Responsibilities

• Oversee credentialing, enrollment, and claims management lifecycle.
• Submit new provider credentialing applications across carriers and networks.
• Manage re-credentialing to prevent lapses in network participation.
• Maintain provider data in credentialing databases and payer portals.
• Collect documentation, licenses, and signatures from providers.
• Review and submit medical claims using EHR/billing systems.
• Apply CPT/HCPCS/ ICD-10 codes and modifiers per guidelines.
• Verify demographics, eligibility, and coverage before claims.
• Monitor payer policies, deadlines, and filing requirements.
• Post payments, adjustments, and write-offs; identify discrepancies.
• Reconcile reports; follow up on unpaid or denied claims.
• Investigate denials and prepare timely appeals with documentation.
• Maintain compliance with HIPAA, CMS, NCQA, and regulations.
• Collaborate with revenue cycle teams to resolve issues.
• Serve as liaison between providers and payers to resolve enrollment issues.

Skills

Attention to detail

Organizational skills

Time management

Problem-solving

Verbal and written communication

Remote work productivity

Education

Associate or Bachelor's preferred

High school diploma required

Tools

CAQH ProView

NPPES

PECOS

Availity

Payer portals

EHR or billing software

Job description

Jobgether SRL is seeking a Medical Insurance Credentialing Specialist based in Portugal. The role focuses on provider credentialing, enrollment, and claims management in a remote healthcare environment, coordinating with payers, providers, and internal teams to ensure compliant, timely reimbursement.

Responsibilities include preparing credentialing applications, managing re-credentialing, data accuracy across systems, and resolving denials while ensuring payer policies and deadlines are met.