Job Title: Medical Biller – Credentialing & AR Specialist

Experience Required: 4–5 years of experience in US Healthcare Medical Billing, AR Follow-up, and Provider Credentialing

Shift: Night Shift – Monday to Friday

Week Off: Saturday & Sunday – Fixed Off

Job Type: Full-time and Remote role

Job Summary

We are seeking an experienced Medical Biller – Credentialing & AR Specialist with strong hands-on experience in US healthcare medical billing, accounts receivable (AR) follow-up, payer enrollment, and provider credentialing.

The ideal candidate will be responsible for managing the complete billing and revenue cycle process, including claim submission, payment posting, denial management, AR follow-up, insurance verification, and payer correspondence. The role will also involve provider credentialing and enrollment with commercial and government payers, ensuring providers remain credentialed, compliant, and eligible to participate in insurance networks.

The successful candidate should have a robust understanding of the US healthcare revenue cycle, insurance payer processes, CPT/HCPCS and ICD-10 coding concepts, claim forms, EOBs/ERAs, denials, appeals, and payer portals. Excellent communication skills are essential, as the role requires regular interaction with US insurance companies and payer representatives through phone calls and online portals.

Key Responsibilities

Medical Billing & Claims Management

- Handle end-to-end US medical billing processes, from charge entry and claim submission through payment posting and account resolution.
- Review and submit electronic and paper claims to commercial, Medicare, Medicaid, and other insurance payers.
- Verify patient insurance eligibility and benefits when required.
- Review claims for accuracy, completeness, and payer-specific requirements before submission.
- Identify and correct claim errors, rejections, and billing discrepancies.
- Work with payer portals and clearinghouses to monitor claim status and resolve outstanding issues.
- Review EOBs, ERAs, and payer correspondence to determine appropriate account action.

AR Follow-Up & Denial Management





- Perform regular AR follow-up and insurance calling to resolve unpaid, underpaid, denied, and delayed claims.
- Contact insurance companies and payer representatives to obtain claim status, payment information, denial reasons, and resolution timelines.
- Investigate and resolve outstanding accounts within assigned aging buckets.
- Follow up on 30/60/90 day AR and prioritize high-value and aging accounts.
- Analyze denial trends and take appropriate corrective action.
- Prepare and submit corrected claims, reconsiderations, and appeals as required.
- Document all payer interactions, follow-up activities, and account updates accurately in the billing system.
- Escalate unresolved payer issues and complex accounts appropriately.

Provider Credentialing & Payer Enrollment

- Manage provider credentialing and payer enrollment activities for healthcare providers.
- Complete and maintain provider applications with commercial and government insurance payers.
- Manage enrollment through payer portals and systems such as CAQH and other applicable platforms.
- Maintain accurate provider demographic, licensure, NPI, taxonomy, malpractice, and practice information.
- Track credentialing and enrollment applications from submission through approval.
- Follow up with payers regarding pending applications, revalidations, effective dates, and participation status.
- Maintain credentialing records and ensure timely renewals and re-credentialing.
- Identify and resolve enrollment-related issues that may affect claim processing or reimbursement.
- Coordinate with internal teams and providers to obtain required documentation.

Required Skills & Qualifications

- 4–5 years of hands-on experience in US healthcare medical billing and credentialing.




- Prior experience in provider credentialing and payer enrollment is required.
- Strong experience with insurance AR calling and payer follow-up.
- Good understanding of the US healthcare revenue cycle management process.
- Knowledge of Medicare, Medicaid, commercial insurance, and other major payer processes.
- Working knowledge of CPT, HCPCS, ICD-10, NPI, taxonomy, EOB/ERA, claim forms, and denial codes.
- Experience working with payer portals and clearinghouses.
- Strong understanding of claim denials, rejections, underpayments, and appeals.
- Excellent verbal and written communication skills.
- Comfortable communicating directly with US insurance representatives.
- Strong analytical, follow-up, documentation, and problem-solving skills.
- Ability to manage multiple providers, accounts, payers, and priorities simultaneously.
- Proficiency in Microsoft Excel and healthcare billing/RCM software.

Preferred Experience
- Experience working with physician practices, clinics, hospitals, or other US healthcare organizations.
- Experience with credentialing, re-credentialing, payer contracting, and enrollment maintenance.
- Experience handling high-volume AR accounts and complex denials.
- Familiarity with CAQH and major payer enrollment systems.
- Experience with medical billing software, EHR/EMR systems, and clearinghouse platforms.

Key Performance Expectations
- Timely and accurate claim submission.
- Effective reduction of outstanding AR and aging balances.
- Successful resolution of denied and rejected claims.
- Accurate and consistent payer follow-up documentation.
- Timely completion of credentialing and payer enrollment activities.
- Maintaining provider participation and enrollment records accurately.
- Meeting individual and team productivity and quality targets.

Work Schedule

Shift: Night Shift – Monday to Friday

Days Off: Saturday & Sunday – Fixed Off

Employment Type: Full-time and Remote Role

This role is aligned with US business hours and requires candidates who are comfortable working the night shift from India.

Pay: ₹30,556.03 - ₹39,512.05 per month

Work Location: Remote

📌 Medical Biller - Credentialing & AR Specialist (India)
🏢 Square RCM
📍 India