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Medical Billing & Provider Credentialing Specialist

1 hour, 41 minutes ago
Philippines
Full-time
Mid Level
Operations Specialist
Operations
Apply Now
Staffing For Doctors

Staffing For Doctors

Staffing For Doctors provides virtual medical staffing solutions for healthcare practices, connecting them with top HIPAA-compliant candidates to enhance operational efficiency, reduce overhead costs, and improve patient care through dedicated virtual ...

Health Care Providers & Services
Founded 2025
View All Jobs 13

Description

  • Oversee end-to-end provider credentialing, including primary source verification for incoming clinical providers.
  • Manage provider onboarding tasks such as CAQH profiles, NPI updates, and commercial and government insurance panel applications.
  • Monitor, maintain, and renew provider credentials, licenses, and insurance panel memberships to prevent billing interruptions.
  • Audit and process clinical notes daily in SimplePractice to support accurate and timely claim submission.
  • Track, appeal, and resolve insurance denials and contact payers to troubleshoot payment delays and claim discrepancies.
  • Maintain billing records in the EMR, adjust claims, and manage patient balances accurately.
  • Serve as the primary point of contact for patient and client billing inquiries by phone and secure messaging.
  • Explain insurance benefits, deductibles, copays, and outstanding balances clearly and professionally.
  • Establish payment plans and follow up on overdue client accounts according to practice policies.
  • Use SimplePractice and Weave to manage administrative documentation, scheduling updates, billing codes, calls, and team communications.

Requirements

  • Experience handling provider credentialing, onboarding, and primary source verification processes.
  • Familiarity with CAQH, NPI updates, and commercial or government insurance panel applications.
  • Ability to maintain active provider credentials, licenses, and panel memberships with attention to compliance deadlines.
  • Experience with clinical billing, claims processing, denials management, and insurance payer follow-up.
  • Comfort working in SimplePractice or a similar EMR/billing system; expert-level SimplePractice navigation is preferred.
  • Ability to communicate professionally with clients about billing questions and financial responsibilities.
  • Experience managing patient balances, payment plans, and overdue account follow-up.
  • Familiarity with the Weave phone system or similar telephony tools for calls and messaging.
  • Ability to work independently and reliably in a full-time Monday–Friday administrative schedule.

Interested in this position?

Apply directly on the company website

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