Medical Billing and Credentialing Specialist (US Startup Company)

Work Arrangement: Fully remote, overlapping EST working hours

Job Type: Full-time

Work Schedule: 40 hours per week, Monday to Friday, 9:00AM - 5:00PM/ 10:00AM - 6:00PM EST

Locations: Remote, open only to candidates based in the Philippines

About Pearl Talent:

Pearl works with the top 1% of candidates from around the world and connects them with the best startups in the US and EU. Our clients have raised over $5B in aggregate and are backed by companies like OpenAI, a16z, and Founders Fund. They’re looking for the sharpest, hungriest candidates who they can consistently promote and work with over many years. Candidates we’ve hired have been flown out to the US and EU to work with their clients, and even promoted to roles that match folks onshore in the US.

Why Work with Us?

We mean what we say that we’re building a different recruiting company here. We only work with exceptional founders from the US and EU who care about the long-term success of their team members. We also provide you with attainable 3, 6, 9, 12 month, and beyond retention bonuses in addition to community oriented opportunities like an annual retreat.

About the Company:

The company specializes in providing compassionate and effective mental health and therapy services to individuals, families, and groups. Committed to improving lives through evidence-based practices, it is renowned for its supportive environment, client-focused approach, and dedication to fostering emotional and mental wellness. The company takes pride in delivering exceptional care while maintaining high operational standards, ensuring a seamless experience for both clients and staff.

Role Overview:

The Medical Billing and Credentialing Specialist will oversee billing and credentialing processes, ensuring accurate claims submission, payment reconciliation, and compliance with insurance requirements. They will manage coding, posting ERAs, analyzing aging reports, and maintaining CAQH and NPI profiles. Acting as a liaison between providers, payers, and clients, they will address inquiries, resolve issues, and ensure HIPAA compliance. The role also involves preparing reports, streamlining processes with leadership, and supporting efficient revenue cycle management.

Key Responsibilities:

1. Billing and Revenue Cycle Management

• Accurately code medical appointments and procedures to ensure proper claims submission.
• Post electronic remittance advices (ERAs) and reconcile payments to maintain accurate financial records.
• Analyze aging reports to identify overdue accounts and implement follow-up actions to resolve outstanding payments.

2. Credentialing and Compliance Oversight

• Maintain and update provider profiles in CAQH and NPI registries to ensure accurate credentialing with insurance networks.
• Ensure compliance with payer credentialing requirements, including timely submission of renewals and documentation.
• Act as a liaison between providers, payers, and leadership to address credentialing or enrollment issues.

3. Administrative and Client Coordination

• Respond to client inquiries regarding billing issues, insurance claims, and payment status.
• Collaborate with leadership to streamline billing processes and ensure HIPAA-compliant handling of sensitive client data.
• Prepare and maintain detailed financial and credentialing reports for internal review and decision-making.

Requirements

• Minimum of 3-5 years of experience in medical billing, revenue cycle management, or credentialing roles, preferably in healthcare or therapy settings.
• Proficiency in medical coding, claims submissions, posting ERAs, and analyzing aging reports.
• Experience with credentialing processes, including maintaining CAQH and NPI profiles and ensuring payer compliance.
• Familiarity with billing and practice management software, and knowledge of HIPAA compliance standards.
• Strong organizational skills, exceptional attention to detail, and the ability to manage multiple tasks efficiently.
• Excellent communication skills with a proactive, problem-solving mindset and the ability to work both independently and collaboratively.

Benefits

• Remote Work: Fully remote—work from anywhere
• Work Schedule: Monday to Friday, 9:00AM - 5:00PM/ 10:00AM - 6:00PM EST
• Generous PTO: Ample paid time off to rest and recharge
• Health Coverage: HMO coverage after 3 months for full-time employees
• Direct Mentorship: Grow through guidance from international industry experts
• Learning Development: Ongoing access to resources for professional growth
• Global Networking: Work and connect with professionals around the world
• Work-Life Balance: Flexible hours that support a healthy work-life balance

Our Recruitment Process:

1. Application
2. Screening
3. Skills Assessment
4. Top-grading interview
5. Client Interview
6. Job Offer
7. Client Onboarding

Ready to Join Us?

If this role aligns with your skills and career goals, we’d love to hear from you. Apply now to take the next step in your journey with Pearl.