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3 results for Credentialing Specialist in St. Paul, MN

Medical Denials Specialist

Saint Paul, MN
remote
Temporary / Contract
25 - 27 USD / Hourly
We are looking for a detail-oriented Medical Denials Specialist to support revenue cycle performance for a healthcare organization. This Contract position focuses on resolving complex claim issues, improving reimbursement outcomes, and maintaining strong follow-up across payer accounts within the outpatient and behavioral health space. The ideal candidate will bring experience in medical billing and accounts receivable work, with the ability to investigate denials, coordinate corrections, and keep account documentation current and accurate. Responsibilities:• Investigate unpaid, partially paid, denied, or rejected medical claims and take appropriate steps to secure accurate reimbursement from insurance carriers.• Determine the underlying cause of claim issues and complete the necessary actions, including corrected submissions, formal appeals, account updates, and requests for supporting records.• Draft and send well-supported appeal correspondence in accordance with payer deadlines, documentation standards, and reimbursement policies.• Manage open accounts receivable by reviewing aging reports, prioritizing follow-up activity, and working toward established resolution goals.• Communicate with payers to verify claim status, clarify payment decisions, and elevate unresolved matters when additional review is required.• Examine differences between charges billed and payer processing results to identify payment variances and recover outstanding balances.• Partner with billing, coding, and clinical teams to address claim edits, authorization concerns, and denial issues tied to documentation or coding accuracy.• Prepare reporting on denial activity, payer behavior, and receivables performance to help identify improvement opportunities within the revenue cycle process.
2026-06-15T00:00:00Z

Medical Insurance Verification Specialist

Saint Paul, MN
remote
Temporary / Contract
15.39 - 18 USD / Hourly
A National Healthcare Company is seeking a detail-oriented Medical Insurance Verification Specialist with 2+ years of experience to join our team in a fully remote capacity. In this role, the Medical Insurance Verification Specialist will be responsible for verifying patient insurance coverage, obtaining benefit information, and ensuring accurate documentation prior to services being rendered. Company-issued equipment will be provided to support your success in this remote position.Key Responsibilities:<ul><li>Verify patient insurance eligibility, benefits, and coverage details prior to appointments or procedures</li><li>Work with a variety of insurance plans, including HMO, PPO, Medicare, and Medicaid</li><li>Confirm referrals, authorizations, copays, deductibles, and out-of-pocket responsibilities</li><li>Communicate with insurance carriers, provider offices, and internal teams to resolve coverage issues</li><li>Accurately document verification details in patient accounts and internal systems</li><li>Identify and escalate discrepancies or denials as needed</li><li>Maintain compliance with HIPAA and company policies</li></ul>
2026-06-10T00:00:00Z

Medical Insurance Verification Specialist (Remote)

Saint Paul, MN
remote
Temporary / Contract
16.39 - 18 USD / Hourly
A National Healthcare Company is seeking a detail-oriented Medical Insurance Verification Specialist with 2+ years of experience to join our team in a fully remote capacity. In this role, the Medical Insurance Verification Specialist will be responsible for verifying patient insurance coverage, obtaining benefit information, and ensuring accurate documentation prior to services being rendered. Company-issued equipment will be provided to support your success in this remote position.Key Responsibilities:<ul><li>Verify patient insurance eligibility, benefits, and coverage details prior to appointments or procedures</li><li>Work with a variety of insurance plans, including HMO, PPO, Medicare, and Medicaid</li><li>Confirm referrals, authorizations, copays, deductibles, and out-of-pocket responsibilities</li><li>Communicate with insurance carriers, provider offices, and internal teams to resolve coverage issues</li><li>Accurately document verification details in patient accounts and internal systems</li><li>Identify and escalate discrepancies or denials as needed</li><li>Maintain compliance with HIPAA and company policies</li></ul>
2026-06-10T00:00:00Z