Job Overview

Our client is seeking an experienced, detail-oriented Medical Billing, Credentialing & Contracting Virtual Assistant to support US medical billing and revenue cycle operations. The primary focus is accurate claims submission, denial follow-up, accounts receivable, and payment reconciliation. The role also provides administrative support for provider credentialing, insurance enrollment, and payer contracting, prioritized around billing deadlines and agreed workloads within a 40-hour workweek. The ideal candidate has practical experience with US healthcare providers, payer portals, and billing systems, and can manage assigned workflows independently while maintaining accurate records and protecting confidential patient information.

Schedule

Monday - Friday, 8:00 AM - 5:00 PM MST, with 1 hour unpaid break (40 work hours per week)

Responsibilities

• Provider Credentialing & Insurance Enrollment (Primary Focus):
  • Assist with credentialing and enrollment applications for Medicare, Medicaid, and commercial payers.
  • Collect and verify provider licenses, certifications, NPI details, and supporting documentation.
  • Complete and maintain CAQH profiles and provider information updates.
  • Track application progress, recredentialing requirements, renewals, and deadlines.
  • Follow up with payers on pending applications and missing requirements.
• Medical Billing & Claims Management (Secondary Focus):
  • Enter and maintain accurate patient, provider, and insurance information.
  • Review claims for completeness and accuracy, and submit them within payer deadlines.
  • Monitor claim statuses through billing systems, clearinghouses, and payer portals.
  • Investigate rejected, denied, or unpaid claims; complete corrections, resubmissions, and appeals as appropriate.
  • Document claim activity, follow-up actions, payments, and outstanding balances.
• Accounts Receivable & Collections (Secondary Focus):
  • Prioritize outstanding insurance balances by age, value, and filing or appeal deadlines.
  • Follow up with insurers to resolve payment delays, discrepancies, and unpaid claims.
  • Assist with payment reconciliation and maintain accurate accounts receivable reports.
  • Identify recurring reimbursement issues and escalate unresolved or complex cases.
  • Recommend practical improvements to follow-up processes and collections workflows.
• Insurance Contracting & Payer Relations (Secondary Focus):
  • Assist with payer contracting applications and provider network participation requirements.
  • Track submissions, approvals, effective dates, and renewals.
  • Maintain organized payer agreements and fee schedules.
  • Flag discrepancies between contracted rates and reimbursements for review.
  • Coordinate outstanding requirements with payer representatives and the designated internal contact.
• Administration & Reporting (Secondary Focus):
  • Maintain accurate records in billing systems, spreadsheets, and internal databases.
  • Provide regular updates on claims, outstanding balances, collections, and credentialing or contracting progress.
  • Communicate with providers, insurers, and internal team members to resolve assigned issues.
  • Flag competing deadlines or workload constraints early so priorities can be adjusted.
  • Handle patient and provider information in accordance with HIPAA requirements and established security procedures.

Requirements

• 2–3 years of relevant experience in US medical billing or healthcare administration, including hands-on claims processing.
• Practical experience with insurance follow-ups, accounts receivable, collections, and denied or rejected claims.
• Strong understanding of medical billing workflows and revenue cycle management.
• Working knowledge of provider credentialing, insurance enrollment, and payer contracting processes.
• Familiarity with CAQH, NPI, Medicare, Medicaid, and commercial insurance requirements.
• Experience using payer portals and communicating with insurance representatives.
• Working knowledge of HIPAA requirements and patient data confidentiality.
• Must have a dual-monitor setup
• Strong written and verbal English communication skills.
• Excellent attention to detail, organization, and time management.
• Ability to work independently, manage agreed priorities, and escalate issues appropriately.

Nice to Have

• Experience supporting physician practices or third-party medical billing companies.
• Familiarity with EHR, EMR, practice management systems, and electronic claims clearinghouses.
• Knowledge of CPT, ICD-10, and HCPCS coding.
• Experience with denial management, appeals, payer fee schedules, and reimbursement reviews.
• Experience supporting multiple providers or medical practices.

Performance Measures

Performance will be assessed against agreed targets that reflect assigned claim volumes, case complexity, payer response times, and the 40-hour workweek. Measures include:

• Accuracy and timeliness of claims submission and billing data entry.
• Completion of assigned claims and follow-ups within agreed turnaround times.
• Timely action on rejected, denied, and outstanding claims.
• Progress in resolving aged receivables and collecting outstanding payments, accounting for payer-dependent delays.
• Accuracy and completeness of records, payment reconciliation, and reports.
• Timely submission and follow-up of assigned credentialing and contracting applications, with payer approval timelines tracked separately.
• Consistent communication, deadline tracking, and escalation of unresolved issues.

Independent Contractor Perks

• Permanent work from home
• Immediate hiring
• Health Insurance Coverage for eligible locations

Note

Please click the "Apply" button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.

One application, multiple possibilities: When you apply, our team reviews your background against all current openings, not just this one! If a different role fits your skills, we'll get in touch! We also encourage you to keep exploring our job board and apply directly to any position that excites you.