Insurance Biller

Role and Responsibilities

Empathy Primary Care, a U.S.-based medical practice, is seeking a skilled credentialing and billing specialist to remotely oversee insurance provider enrollment and billing activities. This position is crucial in ensuring providers remain properly credentialed with insurers and that billing processes operate efficiently.

• Oversee the complete provider credentialing and enrollment process with commercial insurers, Medicare, and Medicaid.
• Create and update CAQH profiles and maintain payer portals current.
• Monitor and accomplish re-credentialing and revalidation cycles before their expiration dates.
• Prepare and submit provider enrollment paperwork through NPPES, PECOS, and insurer-specific portals.
• Conduct billing tasks including charge entry, claims submission, and payment posting.
• Follow up on denied or rejected claims and manage accounts receivable.
• Collaborate with U.S.-based team members regarding documentation and insurer communication.
• Ensure adherence to HIPAA regulations and confidentiality standards at all times.

Preferred Candidate Profile and Required Qualifications

• Demonstrated experience with U.S. medical insurance credentialing systems such as CAQH, PECOS, NPPES, and payer enrollment websites.
• Familiarity with U.S. medical billing and claims processes, including CMS-1500 forms, ICD-10 diagnoses, and CPT coding.
• Knowledge of major U.S. health insurers including Medicare, Medicaid, and commercial payers.
• Proficient verbal and written English communication skills.
• Ability and willingness to work overlapping hours aligned with U.S. business schedules.
• Previous employment with a U.S. medical practice or billing service is highly advantageous.