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24/7 DCT

24/7 DCT

via Indeed

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Senior Billing & Credentialing Specialist

Anywhere
full-time
Posted 10/6/2025
Verified Source
Key Skills:
Medical billing
Provider credentialing
Claims submission
Insurance verification
Multi-state provider enrollment
Healthcare compliance
CPT, ICD-10, HCPCS coding
Billing software (Kareo, AdvancedMD, AthenaHealth, Epic)
Leadership and mentoring

Compensation

Salary Range

$45K - 50K a year

Responsibilities

Manage end-to-end medical billing and provider credentialing processes including claims submission, insurance verification, multi-state enrollment, compliance, and mentoring junior staff.

Requirements

Minimum 5 years experience in medical billing and credentialing, knowledge of coding and billing software, leadership skills, and preferred certifications such as CPB, CBCS, or CPCS.

Full Description

Job Title: Senior Billing & Credentialing Specialist Location: Oak Brook, IL (Hybrid / Remote) Employment Type: Full-time Salary Range: $45,000 – $50,000 Annually Reports To: Billing Manager / Credentialing Manager Position Summary: We are seeking an experienced Senior Medical Biller & Credentialing Specialist to manage both end-to-end medical billing and provider credentialing processes for our healthcare organization. The ideal candidate will have expertise in claims submission, insurance verification, multi-state provider enrollment, and compliance with federal and state regulations. This dual-role is critical for ensuring accurate revenue cycle management and smooth credentialing operations. Key Responsibilities: Medical Billing: • Prepare, review, and submit claims to insurance carriers and government payers (Medicare, Medicaid, commercial insurance). • Verify patient insurance eligibility and benefits. • Post payments, reconcile accounts, and manage co-pays, deductibles, and adjustments. • Follow up on unpaid or denied claims and appeal when necessary. • Collaborate with providers and clinical staff to resolve coding or documentation issues. • Generate billing reports and ensure compliance with HIPAA and other regulations. Provider Credentialing: • Manage full-cycle credentialing and re-credentialing for new and existing providers across multiple states. • Ensure compliance with state, federal, and accreditation standards (NCQA, URAC, JCAHO, HIPAA). • Prepare the organization for audits and maintain certification readiness. • Collaborate with providers, payers, and leadership to resolve escalated credentialing issues. • Mentor junior staff on credentialing and billing processes. • Identify opportunities to optimize reimbursement rates and support payer contract discussions. Required Skills & Competencies: • Strong knowledge of CPT, ICD-10, HCPCS coding, medical billing, and claims processes. • Expertise in multi-state provider credentialing, payer enrollment, and healthcare compliance. • Experience with medical billing and credentialing software (e.g., Kareo, AdvancedMD, AthenaHealth, Epic). • Excellent analytical, organizational, and communication skills. • Leadership and mentoring capabilities. • Professionalism, attention to detail, and discretion with sensitive information. Qualifications: • Bachelor’s degree in Healthcare Administration, Business, or related field preferred. • Minimum 5 years of experience in both medical billing and provider credentialing. • Certification such as CPB, CBCS, or Certified Provider Credentialing Specialist (CPCS) preferred. Experience in high-volume healthcare organizations is a plus. Job Type: Full-time Pay: $45,000.00 - $50,000.00 per year Benefits: • Dental insurance • Health insurance • Paid time off • Vision insurance Work Location: Remote

This job posting was last updated on 10/10/2025

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