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1 result for Credentialing Specialist in Edison, NJ
- Philadelphia, Pennsylvania
- onsite
- Temporary / Contract
- 0 - 0 USD / Yearly
- We are looking for a Medical Billing Specialist to support revenue cycle operations for a healthcare setting in Philadelphia, Pennsylvania. This Contract position focuses on accurate claim handling, payer follow-up, and timely reimbursement across multiple insurance types, including Keystone, auto, workers’ compensation, and commercial plans. The ideal candidate brings strong billing knowledge, sharp attention to detail, and the ability to manage claim activity efficiently in a fast-paced environment.<br><br>Responsibilities:<br>• Process and submit medical claims for multiple payer categories, ensuring each submission is complete, accurate, and aligned with insurance guidelines.<br>• Investigate unpaid, delayed, or denied claims and work with payer representatives to drive resolution and secure payment.<br>• Review billing records for errors or inconsistencies, make necessary corrections, and promptly refile claims when needed.<br>• Monitor payer-specific rules, reimbursement terms, coding standards, and applicable billing regulations to maintain compliance.<br>• Coordinate with internal teams such as coding, registration, and clinical staff to gather information needed for clean claim processing.<br>• Respond to insurance requests and provide supporting documentation to address claim questions or outstanding issues.<br>• Record account activity, update claim status notes, post remittance details, and reconcile payer and patient balances.<br>• Contribute to denial review efforts and support audit-related activities by maintaining thorough and accurate billing documentation.
- 2026-09-25T00:00:00Z