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, bolthires, bolthires, bolthires, UHC, and other major payersMaintain and update CAQH profilesHandle revalidation, recredentialing, and insurance panel updatesClaims ManagementCreate and submit accurate claims (CMS-1500 / UB-04)Ensure all claims meet payer-specific requirements and HIPAA standardsHandle claim rejections, denials, and resubmissions efficientlyPerform EOB analysis and payment postingAccounts Receivable (A/R) & Follow-upTrack unpaid or denied claims and follow up with payersIdentify and resolve root causes of denialsPrepare aging reports and maintain updated A/R logsReporting & CommunicationProvide weekly claim and payment reportsMaintain transparent communication with providers or practice managersSuggest process improvements for faster reimbursementRequired Skills &Experience:Minimum 3 years of hands-on experience in U.S.medical billingStrong knowledge of RCM, CPT, ICD-10, and HCPCS codingExperience with credentialing, claim submission, and payer enrollmentProficiency with EHR/EMR systems such as Kareo (Tebra), Office Ally, AdvancedMD, eClinicalWorks, TherapyNotes, or WebPTFamiliarity with clearinghouses like Availity, Trizetto, or Change HealthcareStrong English communication skills100% HIPAA-compliant workflowPlease include the following when applying:A short summary of your billing and credentialing experienceSoftware and payers you’ve worked withExample of a challenge you resolved (denial or claim issue)Your availability and preferred working hours Apply tot his job