Medical Biller / Credentialing Specialist

Job Description

Job Description

Position Overview

We are seeking an experienced Medical Biller / Credentialing Specialist to join our Internal Medicine and Dialysis practice in Stockbridge, Georgia.

The ideal candidate will have a strong background in medical and dialysis billing, insurance follow-up, accounts receivable, and provider credentialing . Proficiency with Waystar and an EMR system is required . Experience with eClinicalWorks is a plus .

This position is ideal for a self-motivated professional who can manage billing and credentialing responsibilities efficiently while maintaining accurate records and strong communication with payers and providers.

Required Qualifications

• Minimum 2 years of medical billing experience .
• Dialysis billing experience required.
• Hands-on experience with Waystar required.
• Hands-on EMR experience required.
• Provider credentialing and payer enrollment experience required.
• Knowledge of Medicare, Medicaid, Medicare Advantage, and commercial insurance plans.
• Experience with claims submission, payment posting, denials, appeals, and A/R follow-up.
• Working knowledge of CAQH, NPI, PECOS, and payer enrollment processes.
• Knowledge of ICD-10, CPT, and HCPCS coding.
• Understanding of HIPAA and medical billing compliance.
• Excellent organization, attention to detail, and follow-through.
• Strong written and verbal communication skills.

Responsibilities

• Manage the full billing cycle for Internal Medicine and dialysis services.
• Submit and monitor claims through Waystar .
• Review claims for accuracy and resolve rejected or denied claims.
• Conduct insurance follow-up and manage outstanding accounts receivable.
• Post insurance and patient payments accurately.
• Investigate payment discrepancies, denials, and underpayments.
• Verify insurance eligibility and benefits as needed.
• Manage provider credentialing, recredentialing, and payer enrollment.
• Maintain and update provider information through CAQH and other payer portals.
• Track credentialing applications and follow up with insurance companies.
• Maintain current provider documentation, including licenses, certifications, and malpractice coverage.
• Assist with Medicare, Medicaid, and commercial payer enrollment.
• Communicate with insurance representatives, providers, dialysis facilities, and internal staff to resolve billing and credentialing issues.
• Maintain accurate and confidential records in accordance with HIPAA requirements.
• Support the practice's overall revenue-cycle and administrative operations.

Preferred Experience

• Experience in Internal Medicine, Nephrology, Dialysis, or primary care .
• eClinicalWorks experience is a plus.
• Familiarity with BCBS, Aetna, Cigna, UnitedHealthcare, Medicare Advantage, and other commercial payers.
• Experience handling complex insurance issues and dialysis-related claims.
• Strong problem-solving skills and the ability to work independently.
• Ability to prioritize multiple deadlines in a fast-paced medical environment.

Compensation & Benefits

Competitive salary based on experience and qualifications.

Benefits may include paid time off, health insurance, and other benefits based on eligibility.

Please submit a resume highlighting your medical and dialysis billing, Waystar, EMR, credentialing, and revenue-cycle experience .

Qualified candidates must meet the required billing, dialysis, Waystar, EMR, and credentialing experience requirements.