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67 results for Credentialing Specialist jobs

Credentialing Specialist

Somerset, NJ
onsite
Temporary / Contract
21 - 23 USD / Hourly
We are looking for a Credentialing Specialist to support a health pharm/biotech organization in Somerset, New Jersey. This Long-term Contract position is ideal for someone who is highly organized, service-minded, and comfortable handling detailed administrative work with accuracy. The role focuses on maintaining credentialing records, coordinating documentation, and providing responsive support to internal and external stakeholders. Responsibilities: • Manage credentialing files by collecting, reviewing, and updating required documentation to keep records complete and current. • Enter and maintain provider or role-related information in internal systems with a strong focus on accuracy and timeliness. • Communicate with stakeholders by email and other channels to resolve missing information and support credentialing activities. • Track application status, follow up on outstanding items, and help ensure deadlines are met throughout the credentialing process. • Use Microsoft Outlook to coordinate correspondence, schedule follow-ups, and organize credentialing-related communications. • Provide customer-focused assistance when responding to questions about documentation, status updates, and process requirements. • Review submitted materials for completeness and escalate discrepancies or issues that require additional attention.
2026-08-18T00:00:00Z

Credentialing Specialist

Chicago, IL
onsite
Temporary / Contract
24 - 26 USD / Hourly
We are looking for a Credentialing Specialist to support provider enrollment and reappointment activities. This long-term contract position focuses on coordinating accurate, timely credentialing documentation, maintaining provider records, and helping ensure licenses and certifications remain current. The ideal candidate brings strong follow-through, sound judgment, and the ability to work closely with providers and internal stakeholders to keep credentialing workflows on schedule. Responsibilities:• Experience in NCQA Credentialing for the state of IL• Guide healthcare providers through initial credentialing and recredentialing submissions, ensuring all required materials are completed and returned within established timelines.• Examine application packets for accuracy and completeness, then follow up promptly to resolve missing information or supporting documentation.• Encourage timely submission of signed applications, aiming to secure completed paperwork within 10 days of the original request.• Partner with credentialing team members to gather outstanding records and keep processing deadlines on track.• Enter and maintain provider profiles in credentialing platforms and databases, ensuring information remains current and reliable.• Produce recurring reports on upcoming expirations for licenses, certifications, and related credentials so renewal activity can begin early.• Monitor renewal status for medical licenses, board certifications, liability coverage, and other required credentials to prevent lapses.• Escalate unresolved expiration issues as needed and communicate with providers and medical staff offices to confirm active licensure and privileges.
2026-08-19T00:00:00Z

Credentialing Specialist

Fresno, CA
onsite
Temporary / Contract
23.3 - 25 USD / Hourly
We are looking for a Credentialing Specialist to support provider and clinic staff credentialing operations for a Contract position based in Fresno, California. This role is responsible for coordinating the full credentialing lifecycle, helping ensure practitioners and clinical staff meet regulatory, payer, and accreditation standards. The ideal candidate brings strong attention to detail, sound knowledge of provider enrollment and reappointment processes, and the ability to keep records accurate and timelines on track while working with internal leaders and external organizations. Responsibilities: • Manage end-to-end credentialing, recredentialing, and privileging activities for providers and clinical staff, ensuring records remain complete and current. • Prepare, submit, and monitor credentialing applications, following up with health plans, facilities, and agencies to keep approvals moving forward. • Maintain organized documentation for licenses, certifications, malpractice coverage, and other required compliance materials for all applicable providers. • Monitor expiration dates for licenses, certifications, liability coverage, and related credentials, and coordinate timely renewals to avoid lapses. • Update and maintain provider profiles within credentialing platforms and internal databases, ensuring data accuracy across systems and directories. • Coordinate renewal appointments for clinic staff and track required timelines to support uninterrupted compliance. • Process privileging and reappointment requests for affiliated healthcare facilities when needed and verify supporting documentation. • Review provider listings and directory information for accuracy, correcting demographic and practice location details with payers and partner entities as necessary. • Provide credentialing and privileging verifications and assist with audits, accreditation activities, and other compliance-related assignments. • Participate in training and carry out additional duties as assigned while demonstrating efficient use of time and resources.
2026-08-19T00:00:00Z

Credentialing Specialist

El Segundo, CA
onsite
Temporary / Contract
22 - 28 USD / Hourly
A healthcare company is looking for Credentialing Specialist to join a healthcare organization in El Segundo, California. This Credentialing Specialist is ideal for someone who can quickly step into a busy environment and provide hands-on support to a credentialing team managing a significant workload. The Credentialing Specialist is fully onsite and offers the chance to contribute immediately while helping maintain accurate, timely provider credentialing operations. Key Responsibilities:• Manage credentialing and recredentialing activities for physicians and other healthcare providers, ensuring files are complete, accurate, and submitted on schedule.• Review applications, supporting documents, and licensure records to verify compliance with organizational, payer, and regulatory standards.• Follow up with providers, payers, and internal teams to obtain missing information and resolve outstanding credentialing issues efficiently.• Maintain organized credentialing records and update tracking systems to reflect application status, expirations, and renewals.• Prioritize a high-volume backlog of provider files and move cases forward with strong attention to deadlines and detail.• Coordinate with department stakeholders to support daily credentialing operations and help improve workflow consistency as needs are identified. Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-08-25T00:00:00Z

Medical Credentialing Specialist

El Segundo, CA
onsite
Temporary / Contract
23.12 - 28 USD / Hourly
We are seeking a detail-oriented Medical Credentialing Specialist to support the credentialing and recredentialing process for healthcare providers. This role is responsible for ensuring providers meet all regulatory, accreditation, and payer requirements so they can deliver services and receive reimbursement. .Key Responsibilities:<ul><li>Manage the initial credentialing and recredentialing process for physicians, nurses, and allied health professionals. </li><li>Verify provider qualifications, including licenses, certifications, education, work history, malpractice coverage, and references. </li><li>Prepare and submit credentialing applications to hospitals, health plans, and insurance networks. </li><li>Maintain accurate provider records and ensure all documentation is current and compliant. </li><li>Track application status and follow up with payers, licensing boards, and other agencies as needed. </li><li>Monitor expiration dates for licenses, DEA registrations, board certifications, and insurance documents. </li><li>Ensure compliance with internal policies, payer standards, NCQA, CMS, and other regulatory guidelines. </li><li>Serve as a point of contact for providers and internal departments regarding credentialing status and requirements. </li><li>Assist with audits and reporting related to provider enrollment and credentialing files. .</li></ul>
2026-08-14T00:00:00Z

Credentialing Manager

Long Beach, CA
onsite
Temporary / Contract
32 - 45 USD / Hourly
A healthcare company is looking for an experienced Credentialing Manager to lead credentialing and provider data activities for a healthcare organization in Long Beach, California. This Credentialing Manager position will guide daily operations related to provider onboarding, recredentialing, enrollment support, and data accuracy while maintaining adherence to regulatory and health plan standards. The Credentialing Manager also partners with internal leaders to strengthen workflows, support audit readiness, and promote consistent credentialing practices across the function. Key Responsibilities:• Direct the day-to-day work of credentialing and provider data staff, setting priorities and providing operational guidance.• Lead provider onboarding, reappointment cycles, payer enrollment activity, and privileging coordination to keep processes moving efficiently.• Maintain compliance with applicable accreditation standards, delegated credentialing obligations, and state and federal regulations.• Review credentialing records, provider rosters, and supporting documentation to ensure information remains complete, current, and accurate.• Track team volume and turnaround times, remove workflow obstacles, and support timely resolution of credentialing issues.• Prepare the department for internal and external reviews by conducting audits and addressing gaps before formal assessments occur.• Work with leadership to refine credentialing policies, improve reporting, and enhance departmental procedures.• Oversee provider data integrity across systems and records to support reliable downstream use and regulatory reporting. Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-08-21T00:00:00Z

Eligibility Specialist

Oakland, CA
onsite
Temporary / Contract
25 - 28 USD / Hourly
Eligibility SpecialistJob DescriptionMission-driven organization seeking an Eligibility Specialist to determine eligibility for public assistance and community programs.Responsibilities<ul><li>Conduct eligibility assessments</li><li>Verify applicant documentation</li><li>Maintain confidential records</li><li>Explain program requirements</li><li>Ensure compliance with regulations</li></ul>
2026-08-07T00:00:00Z

Verification Specialist

Eugene, OR
onsite
Temporary / Contract
19 - 21 USD / Hourly
We are looking for a Verification Specialist to support daily attendance and shift confirmation activities for a care-focused team in Eugene, Oregon. This Long-term Contract position is ideal for someone who is comfortable making a high volume of outbound calls, documenting findings accurately, and resolving time-sensitive service issues effectively. The role plays an important part in confirming caregiver coverage, investigating schedule exceptions, and helping maintain reliable service for clients. Responsibilities: • Contact care sites and caregivers to confirm scheduled coverage and verify whether assigned staff have arrived for their shifts. • Respond to attendance concerns when a caregiver has not checked in within the expected timeframe and take appropriate follow-up steps to determine status. • Apply established procedures for missed arrivals and no-call, no-show situations while escalating issues as needed. • Record call outcomes, attendance updates, and exception details accurately in internal systems to maintain complete documentation. • Review completed shifts for irregularities such as late clock-outs, location mismatches, or missing task details and investigate the cause of each variance. • Coordinate with team members to ensure open shift issues are identified quickly and brought to resolution. • Provide consistent communication and attentive customer service during outbound follow-up with caregivers and related contacts. • Support onboarding into the role by learning workflows, compliance steps, and verification protocols required for accurate shift monitoring.
2026-08-25T00:00:00Z

Background Verification Specialist

San Ramon, CA
remote
Temporary to Hire
23 - 25 USD / Hourly
Robert Half is seeking a Background Verification Administrator to join the customer service team. This is a temporary remote position, however, to be eligible you must be located in Pacific Standard Time. The customer service team will partner closely with the Manager, Background Checks to solution customer service issues and continue to educate our branch partners on background check industry standards, processes and best practices. Background Verification Administrator Responsibilities Include:-Monitor and review BGC data via reporting, telephone calls, and CS inbox to identify areas of concern and work closely with field users to determine resolution or escalation as applicable.-Point of contact for internal and external clients on background check submission status, issues or questions related to regulatory compliance.-Leverage customer service reports to support all elements of background checks including development of new processes, training and program opportunities, improving field communication and improve service levels.-Document and maintain tasks specific to customer service, including processes and policies.-Create training for internal clients on operational, technical and compliance processes related to background checks.-Create and manage training content on internal sites on operational, technical and compliance processes related to background checks.-Facilitate training to all end users on RH process and various systems either one on one or on weekly, monthly training calls. Participate in training of new materials and processes.-Maintain customer relationships by responding to background check inquiries and research, document, track actions in case management software.-Participate as primary troubleshooter, proactively monitor and resolve system/vendor inquires or issues in a timely and professional manner.-Collaborate with other BGC Verification team members or corporate department teams to ensure service levels are being met for optimal user satisfaction, and adherence to best practices and government regulations.-Ensure that timely and accurate BGC processing meets or exceeds expected business needs and objectives.-Likely around 100 calls daily (inbound and outbound) and a mixture of emails as well If you are interested in this Background Verification Administrator position, please submit your resume for immediate consideration!
2026-08-24T00:00:00Z

Background Verification Specialist

San Ramon, CA
remote
Temporary to Hire
20 - 21 USD / Hourly
Robert Half is seeking a Background Verification Administrator to join the customer service team. This is a temporary remote position, however, to be eligible you must be located in either Central or Eastern Standard Time. The customer service team will partner closely with the Manager, Background Checks to solution customer service issues and continue to educate our branch partners on background check industry standards, processes and best practices. Background Verification Administrator Responsibilities Include:-Monitor and review BGC data via reporting, telephone calls, and CS inbox to identify areas of concern and work closely with field users to determine resolution or escalation as applicable.-Point of contact for internal and external clients on background check submission status, issues or questions related to regulatory compliance.-Leverage customer service reports to support all elements of background checks including development of new processes, training and program opportunities, improving field communication and improve service levels.-Document and maintain tasks specific to customer service, including processes and policies.-Create training for internal clients on operational, technical and compliance processes related to background checks.-Create and manage training content on internal sites on operational, technical and compliance processes related to background checks.-Facilitate training to all end users on RH process and various systems either one on one or on weekly, monthly training calls. Participate in training of new materials and processes.-Maintain customer relationships by responding to background check inquiries and research, document, track actions in case management software.-Participate as primary troubleshooter, proactively monitor and resolve system/vendor inquires or issues in a timely and professional manner.-Collaborate with other BGC Verification team members or corporate department teams to ensure service levels are being met for optimal user satisfaction, and adherence to best practices and government regulations.-Ensure that timely and accurate BGC processing meets or exceeds expected business needs and objectives.-Likely around 100 calls daily (inbound and outbound) and a mixture of emails as well If you are interested in this Background Verification Administrator position, please submit your application today!
2026-08-24T00:00:00Z

Medical Authorizations Specialist

Los Angeles, CA
onsite
Temporary / Contract
24.07 - 30.12 USD / Hourly
A Hospital in Los Angeles is looking for an experienced Medical Authorizations Specialist to support patient access and revenue cycle operations for a healthcare organization. The Medical Authorizations Specialist position focuses on securing timely insurance approvals, insurance verifications confirming coverage details, and helping patients move forward with needed services without unnecessary delays. The Medical Authorizations Specialist candidate brings strong payer knowledge, sound judgment, and a patient-centered approach in a fast-moving hospital or clinical environment. Responsibilities:• Manage authorization and precertification requests for scheduled and unscheduled services across a range of government and commercial health plans.• Confirm active medical insurance coverage, benefit levels, and service-specific requirements before care is delivered to reduce claim and scheduling issues.• Evaluate provider orders and supporting clinical records to prepare complete submissions that align with payer criteria.• Track open requests, communicate with insurers, and take timely action to obtain determinations within required turnaround times.• Share updates on approval, denial, or pending status with care teams, schedulers, physicians, and patients as needed.• Investigate barriers that could interrupt treatment timelines and work with internal and external parties to resolve them quickly.• Record authorization activity, follow-up efforts, and outcomes accurately within the electronic medical record and related billing systems.• Assist with reconsiderations or appeals when requests are postponed or denied, using documentation that supports medical necessity.• Stay informed on changing payer rules, regulatory expectations, and authorization workflows while protecting patient confidentiality at all times.
2026-08-26T00:00:00Z

Certification & Compliance Specialist

Seattle, WA
onsite
Temporary / Contract
40 - 43 USD / Hourly
We are seeking an organized and detail-oriented FAA Certification & Compliance Specialist to support certification and compliance activities for regulated aviation maintenance positions. This role is responsible for coordinating FAA certificate applications, scheduling FAA interviews, verifying employee qualifications and training, and maintaining certification records. The ideal candidate will be comfortable managing detailed workflows, handling regulated documentation, and identifying opportunities to improve processes and efficiencies.
2026-08-25T00:00:00Z

Credit Specialist

Houston, TX
onsite
Permanent / Full Time
60000 - 64000 USD / Yearly
Our client is looking for a detail-oriented Credit Specialist to support commercial credit and collections activities in Houston, Texas. This position focuses on evaluating customer credit information, helping manage account risk, and promoting timely payment across business accounts. The ideal candidate brings strong analytical ability, sound judgment, and at least 3 years of relevant experience in credit analysis and commercial collections. Responsibilities:• Review commercial credit applications and assess customer financial information to support informed credit decisions.• Monitor account performance and payment trends to identify risk, recommend credit actions, and maintain healthy receivables.• Work directly with business customers to resolve outstanding balances and drive effective commercial collection efforts.• Maintain accurate credit records, account documentation, and supporting analysis within internal systems.• Partner with sales, customer service, and finance teams to address account issues and support credit-related inquiries.• Evaluate credit limits and payment terms based on account history, financial data, and overall risk exposure.• Follow up on overdue invoices, negotiate payment arrangements when appropriate, and escalate concerns as needed.
2026-08-14T00:00:00Z

Credit Specialist

White Bear Lake, MN
onsite
Permanent / Full Time
60000 - 75000 USD / Yearly
We are looking for a Credit Specialist to join our team in St. Paul, Minnesota. In this role, you will assess customer financial risk, support informed credit decisions, and help protect the business from unnecessary exposure while enabling healthy revenue growth. You will work closely with cross-functional partners to resolve credit-related issues, improve accounts receivable outcomes, and strengthen overall credit practices. Key Responsibilities<ul><li>Analyze customer credit applications, financial statements, trade references, and payment histories</li><li>Assess credit risk and recommend approval, denial, or modification of credit terms and limits</li><li>Monitor existing customer accounts for changes in risk profile, delinquency trends, and exposure levels</li><li>Partner with sales, customer service, and finance teams to balance business growth with risk management</li><li>Review aging reports and support collections strategies for past-due accounts</li><li>Assist with collections-related analysis and recommend actions to reduce delinquency and bad debt risk</li><li>Process with customer account reconciliation and respond to statement of account requests</li><li>Maintain accurate customer credit files and documentation</li><li>Prepare credit reviews, risk summaries, and account status reports for management</li><li>Evaluate order holds and release decisions based on account standing and company policy</li><li>Identify potential bad debt risks and recommend preventative actions</li><li>Support continuous improvement of credit policies, procedures, and internal controls</li><li>Assist with dispute resolution related to billing, deductions, and payment issues</li><li>Ensure compliance with internal policies and applicable financial regulations</li></ul>
2026-08-21T00:00:00Z

Licensing Specialist

Monticello, MN
onsite
Temporary to Hire
19 - 21 USD / Hourly
The objective of this role is to ensure the agent contracting process is as smooth and efficient as possible for our agents from start to finish. As a licensing specialist, you will execute professionalism while providing top notch customer service and work to find and create efficiencies. This is an amazing opportunity to join our team in a much-needed position. Whether you are familiar with the insurance background or not, your enthusiasm, motivation, and interest in becoming part of our well-established and positive work environment, makes you an ideal candidate.We value your hard work and dedication to this position, and you can be confident that the opportunities for growth within the corporation will continue to arise. Primary Responsibilities:• Generate and process contracting applications and other required forms for submission on all new and existing agents and agencies within Simplicity.• Completes routine follow-up on submitted agent contracting paperwork to ensure proper processing.• Assist with agent updates, contract changes, while proactively looking for ways to streamline the process to make it as smooth as possible for the agent.• Applies sound insurance knowledge regarding products and services, troubleshooting issues, and working to resolve in the quickest and most efficient way to best meet agent needs.• Provide professional correspondence via email and phone• Work efficiently to meet all service level agreements• Understand carrier workflows and maneuver carrier websites• Work closely with team members to meet common goals and assist when able Qualifications / Requirements:• Minimum of a High school diploma / GED• Strong computer skills; able to type 50+ words per minute• Proficiency in Microsoft Office (Word, Excel)• Experience with G Suite and Salesforce preferred, not required• Experience in related position preferred, not required Core Competencies:• Ability to provide exceptional customer service• Effective time management skills• Ability to prioritize and multitask in a fast-paced environment, and utilize multiple programs simultaneously• Capable of working both independently and in a team environment• Excellent organizational skills, attention to detail is a must• Ability to react to change in a productive and positive manner
2026-08-17T00:00:00Z

Licensing Specialist

New Brighton, MN
onsite
Temporary / Contract
28.5 - 33 USD / Hourly
We are looking for a Licensing Specialist to support compliance and licensing activities for a service-focused organization in New Brighton, Minnesota. This Long-term Contract opportunity is ideal for someone who works independently, communicates clearly, and enjoys researching requirements to keep records accurate and up to date. The role suits someone with strong attention to detail and licensing experience, and candidates with construction industry exposure or knowledge of sales and use tax will be especially well aligned. Responsibilities: • Manage licensing and registration activities by preparing, submitting, and tracking applications, renewals, and supporting documentation. • Research jurisdictional requirements to confirm business licenses, permits, and related compliance obligations are completed accurately and on time. • Review records for completeness and accuracy, resolve discrepancies, and maintain organized documentation for audit readiness. • Partner with internal stakeholders to gather needed information, communicate status updates, and address licensing questions in a timely manner. • Monitor deadlines and regulatory changes that may affect licensing, permit, or tax-related obligations across applicable locations. • Support compliance efforts related to sales and use tax by maintaining records and assisting with documentation reviews as needed. • Investigate issues independently, identify practical solutions, and escalate complex matters when necessary. • Contribute to process consistency by documenting workflows and recommending improvements that strengthen organization and follow-through.
2026-08-21T00:00:00Z

Enrollment Specialist

Carrollton, GA
remote
Temporary / Contract
16.15 - 18.7 USD / Hourly
We are looking for an Enrollment Specialist to support a high-volume insurance call center serving sales teams in Carrollton, Georgia. This Long-term Contract position is ideal for someone who communicates with empathy, stays organized in a fast-paced environment, and maintains precise records while handling frequent benefit-related inquiries. The role focuses on assisting internal sales partners with enrollment support, billing questions, and Medicare-related information, while adapting to fluctuating call demand and scheduled business hours that may include weekdays and some Saturdays. Responsibilities: • Respond to incoming calls from sales representatives and provide timely support for enrollment-related questions and account needs. • Confirm coverage details, eligibility information, billing status, and copay information with a high level of accuracy. • Document each interaction thoroughly in company systems to ensure complete and reliable records. • Manage a steady volume of requests while maintaining professionalism during peak periods when call queues increase significantly. • Support insurance product enrollment activities by guiding internal partners through required information and next steps. • Use multiple computer applications efficiently to research member details, update records, and track case activity. • Assist with operational changes and workflow updates as needed to help maintain service continuity during busy seasons. • Follow assigned work schedules, including weekday shifts and occasional Saturdays, while remaining flexible with hours of operation.
2026-08-14T00:00:00Z

Medical Billing Specialist

Boca Raton, FL
remote
Temporary / Contract
24.7 - 28.6 USD / Hourly
We are looking for a detail-oriented Medical Billing Specialist to support a healthcare organization in Boca Raton, Florida on a Contract basis. This position focuses on coding accuracy, billing compliance, and reimbursement optimization through careful review of documentation and claims activity. The ideal candidate brings strong experience in E/M coding and auditing, along with the ability to work closely with providers and billing teams to improve accuracy and resolve reimbursement issues. Responsibilities:• Conduct secondary reviews of billing activity to confirm compliance with regulatory standards, internal procedures, and reimbursement guidelines.• Examine clinical documentation and coded services to identify missed charges, undercoding, overcoding, or other discrepancies, and document findings in clear audit reports.• Partner with physicians and clinical staff to clarify incomplete or unclear documentation and promote accurate coding and billing practices.• Escalate recurring documentation concerns, coding patterns, and compliance risks to revenue cycle leadership or practice management for follow-up.• Collaborate with billing and revenue cycle teams to support account resolution, including claim corrections, resubmissions, and follow-up tied to accounts receivable performance.• Evaluate payer reimbursement behavior, fee schedule outcomes, denial trends, and policy changes to identify opportunities for improved revenue capture.• Research and address questions related to coding compliance, payer requirements, denials, and appropriate billing for services rendered.• Deliver education, guidance, and ongoing support to providers and staff on coding standards, documentation expectations, and regulatory requirements.• Help maintain compliant billing procedures, charge tools, and related workflows while safeguarding confidential financial and medical information
2026-08-25T00:00:00Z

Medical Billing Specialist

Spring, TX
remote
Temporary to Hire
21 - 24 USD / Hourly
We are looking for a detail-oriented Medical Billing Specialist to join a mission-focused nonprofit organization in Spring, Texas. This contract opportunity with permanent potential is ideal for someone who brings strong Medicaid billing knowledge and wants to support services that positively impact individuals with a wide range of care needs. In this role, you will help protect revenue by ensuring claims are accurate, compliant, and followed through to resolution. You will work closely with internal teams to improve reimbursement outcomes while maintaining high standards of accuracy and regulatory compliance. Responsibilities: • Review patient and client coverage information to confirm Medicaid and other insurance eligibility before billing activity begins. • Prepare and submit Medicaid claims with complete and accurate coding, modifiers, provider identifiers, and supporting billing details to reduce processing issues. • Track claims throughout the reimbursement cycle and address unpaid, denied, delayed, or partially paid balances in a timely manner. • Investigate denial trends, determine underlying causes, and complete appeals or corrected claim submissions to support payment recovery. • Interpret remittance documents, explanation of benefits statements, and payer correspondence to resolve claim discrepancies. • Use payer portals and available resources to verify claim status, identify denial reasons, and document next steps for resolution. • Partner with operational and clinical teams to clarify billing questions and strengthen overall claim quality and reimbursement performance. • Stay informed on Texas Medicaid requirements, managed care plan expectations, and applicable state and federal billing regulations. • Maintain organized records and support audit readiness by following internal policies and established compliance standards.
2026-08-25T00:00:00Z

Medical Billing Specialist

Hopkins, MN
onsite
Permanent / Full Time
50000 - 65000 USD / Yearly
We are looking for a detail-oriented Medical Billing Specialist to support healthcare claims and reimbursement activities in Bloomington, Minnesota. This role focuses on preparing, submitting, and tracking billing for a range of home and community-based services while helping ensure claims are accurate, timely, and fully supported by required documentation. The ideal candidate brings strong knowledge of medical billing workflows, payer requirements, and follow-up practices that improve cash flow and resolve claim issues efficiently. Responsibilities:• Examine service records, authorizations, care plans, and supporting documents to confirm claims are ready for submission to Minnesota Medical Assistance and other applicable payers.• Process and track claims for home care and related community-based services using payer portals, clearinghouses, and revenue cycle platforms.• Investigate unpaid, denied, rejected, underpaid, or recouped claims and take appropriate action to secure correct reimbursement.• Conduct account reviews for aged receivables, including outstanding balances over 30 days, and document follow-up activity in assigned tracking tools.• Analyze remittance information to identify payment variances, denials, adjustments, spend-down impacts, and reimbursement discrepancies.• Resolve billing exceptions by correcting claim details and submitting original, replacement, corrected, or voided claims in line with payer rules.• Review unbilled service lines regularly to ensure eligible charges are captured and submitted without unnecessary delay.• Respond to billing-related questions from internal teams and external partners, including payers, case managers, coordinators, and other stakeholders.• Maintain compliance with state and federal billing standards, documentation expectations, coding requirements, confidentiality obligations, and fraud prevention guidelines.• Escalate high-risk account concerns, authorization mismatches, documentation deficiencies, database inaccuracies, and payer-related barriers to leadership when needed.
2026-07-28T00:00:00Z

Medical Billing Specialist

Portland, OR
onsite
Temporary / Contract
23 - 30 USD / Hourly
We are seeking a detail oriented Medical Billing Specialist in the Portland area. This role is responsible for managing the billing process from claim submission through payment posting and follow up, helping ensure accurate reimbursement, reduced claim denials, and a positive patient financial experience. The ideal candidate has experience working with insurance providers, understands medical billing regulations, and thrives in a fast-paced environment where accuracy and customer service are equally important.Key Responsibilities<ul><li>Prepare, review, and submit accurate medical claims to insurance carriers</li><li>Verify insurance eligibility, benefits, and coverage information</li><li>Monitor claim status and follow up on unpaid or denied claims</li><li>Research and resolve billing discrepancies, denials, and payment issues</li><li>Post payments, adjustments, and patient payments accurately</li><li>Maintain patient billing records and documentation</li><li>Communicate with patients regarding billing questions and account balances</li><li>Work closely with providers, clinical staff, and insurance companies to resolve claim issues</li><li>Ensure compliance with HIPAA and healthcare billing regulations</li><li>Assist with month end reporting and revenue cycle activities as needed</li></ul>
2026-08-21T00:00:00Z

Medical Billing Specialist

Shelton, WA
onsite
Temporary to Hire
25.3365 - 29.337 USD / Hourly
We are looking for a Medical Billing Specialist to join our team in Shelton, Washington in a contract capacity with the potential for a permanent role. This onsite position supports a tribal healthcare setting and plays an important role in keeping billing operations accurate, timely, and compliant. The person in this role will help manage claims, authorizations, referrals, and revenue cycle activities while working closely with patients, providers, and payers. This opportunity is ideal for someone who is comfortable balancing billing detail, insurance coordination, and patient support in a fast-paced clinic environment. Responsibilities: • Oversee the full claims process for medical, dental, Medicare, Medicaid, and commercial coverage, from submission through payment resolution. • Review remittance details, post payments accurately, and investigate denied, rejected, or underpaid claims to secure proper reimbursement. • Track outstanding receivables, follow up on unpaid balances, and take timely action to reduce aging accounts. • Confirm insurance information, patient demographics, and service authorization needs before billing or referral processing begins. • Obtain and manage prior approvals for services while coordinating with clinics, insurers, and external care providers. • Support compliant billing practices by maintaining accurate documentation and applying appropriate coding and privacy standards. • Coordinate referral-related activities, including eligibility review, purchase order processing, claim support, and follow-up with outside providers when needed. • Assist patients with billing questions, insurance-related concerns, and benefit enrollment support, including Healthplanfinder guidance. • Contribute to reporting, audit preparation, reconciliations, and general front-office coverage as needed to support clinic operations.
2026-08-21T00:00:00Z

Medical Billing Specialist

Moline, IL
onsite
Temporary to Hire
18 - 22 USD / Hourly
Advance Your Medical Billing Career Robert Half is partnering with a respected healthcare organization in the Quad Cities area to identify an experienced Medical Billing Specialist. This is an excellent opportunity for a billing professional who enjoys ownership of the revenue cycle, working denials and appeals, analyzing reimbursement issues, and driving successful insurance collections. If you have a strong understanding of medical billing, insurance reimbursement, and claims processing, we'd love to connect with you. What You'll Do<ul><li>Submit medical claims electronically to commercial and government payers</li><li>Post insurance and patient payments accurately and timely</li><li>Research, resolve, and appeal denied or rejected claims</li><li>Follow up with insurance carriers regarding outstanding balances</li><li>Monitor and manage accounts receivable aging</li><li>Identify underpayments, overpayments, and reimbursement discrepancies</li><li>Process refunds and credit balances as needed</li><li>Partner with coding and business office teams to help ensure accurate claim submission</li><li>Support ongoing billing accuracy and compliance initiatives</li><li>Maintain confidentiality and compliance with HIPAA regulations</li></ul> Why This Opportunity?✅ Stable healthcare organization with a patient-focused mission✅ Opportunity to make a direct impact on revenue cycle performance✅ Collaborative team environment✅ Full-time, long-term career opportunity✅ Competitive compensation and benefits package Ready to Learn More? If you're passionate about healthcare administration and enjoy solving reimbursement challenges while helping organizations maintain financial excellence, we'd welcome the opportunity to discuss this position with you. Apply today to be considered. Candidates may also call our team direct at (563) 359-3995 to discuss your short- and long-term goals!
2026-08-13T00:00:00Z

Medical Billing Specialist

Portland, OR
onsite
Temporary / Contract
30.4 - 32 USD / Hourly
We are looking for a Medical Billing Specialist to support a small healthcare clinic in Portland, Oregon within the local government sector. This Long-term Contract opportunity focuses on strengthening billing operations, improving claim accuracy, and promoting compliant reimbursement practices for a targeted set of clinical services. The role will work closely with providers and clinic staff to refine coding workflows, reduce preventable errors, and help establish reliable billing standards. Responsibilities: • Assess existing billing workflows and identify areas where accuracy, efficiency, and compliance can be improved. • Monitor billing activity to ensure alignment with 340B program expectations and other applicable healthcare regulations. • Examine submitted claims, correct discrepancies, and recommend changes that support stronger reimbursement results. • Advise providers on coding methods, modifier usage, and documentation standards needed for clean claim submission. • Manage billing activity for a focused volume of clinic services, typically covering approximately 30 to 35 transactions. • Partner with clinic personnel and leadership to develop practical, repeatable billing procedures that support long-term success. • Investigate billing issues and implement measures that help minimize denials, rework, and payment delays.
2026-08-24T00:00:00Z

Medical Billing Specialist

Shelton, WA
onsite
Temporary / Contract
25 - 35 USD / Hourly
A well-established nonprofit organization in Shelton is seeking a Medical Billing Specialist to support its growing healthcare operations. This role is ideal for a detail-oriented detail oriented who enjoys working in a mission-driven environment and has experience managing the full medical billing cycle. The Medical Billing Specialist will play a key role in ensuring timely and accurate billing, claims processing, payment posting, and revenue cycle support. Key Responsibilities Process and submit medical claims to Medicare, Medicaid, managed care organizations, and commercial insurance providers. Review claims for accuracy and completeness prior to submission. Monitor claim status and proactively follow up on denied, rejected, or unpaid claims. Research and resolve billing discrepancies, payment variances, and reimbursement issues. Post insurance and patient payments accurately and reconcile accounts. Manage accounts receivable aging and conduct collection activities as needed. Verify patient insurance eligibility and benefits. Work closely with providers, clinical staff, and leadership to resolve billing concerns and improve reimbursement processes. Maintain compliance with payer guidelines, HIPAA regulations, and organizational policies. Assist with reporting, audits, and month-end revenue cycle activities.
2026-08-12T00:00:00Z