Credentialing and Claims Specialist

Winning Assistants LLC

Credentialing & Claims Specialist assisting with insurance credentialing and claims resolution for a behavioral health practice. Focus on resolving claims and improving operational workflows in a remote setting.

Posted 5/26/2026full-timeRemote • 🇵🇭 PhilippinesMid-LevelSenior💰 $6 - $7 per hourWebsite

About the role

Key responsibilities & impact

Manage rejected claims follow-up and resolution
Track claim submissions and monitor for denials or rejections
Investigate claim issues and coordinate corrective actions
Communicate directly with insurance companies regarding billing and reimbursement concerns
Handle insurance credentialing fixes and provider enrollment issues
Ensure provider credentialing remains updated and active within insurance systems and Tebra Care
Process insurance verification and eligibility checks
Support copay collection and insurance coordination workflows
Manage prior authorization workflows
Transfer patient information from Zocdoc into Tebra EMR
Assist with schedule management and calendar optimization
Maintain organized follow-up systems and documentation tracking
Collaborate closely with internal staff to support operational efficiency

Requirements

What you’ll need

Strong experience with medical billing, claims processing, and insurance workflows
Expertise handling claim denials, rejected claims, and underpayments
Prior credentialing experience is REQUIRED
Experience communicating directly with insurance companies regarding claims and credentialing issues
Strong attention to detail and organizational ability
Ability to independently manage multiple follow-ups and deadlines
Professional written and verbal communication skills
Collaborative mindset and ability to work effectively with internal staff
Must-Have Experience: Tebra Care (required)
Familiarity with multiple EHR/EMR systems
Experience working with insurance portals and billing systems
Basic requirements: Must be proficient in speaking and writing English very clearly
Must have relevant work experience
Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory]
Must be available for video meetings with your camera on (when needed)

Benefits

Comp & perks

Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication.
Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks.
HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients.
Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention.
Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule.
Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client.
Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best.
Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

medical billingclaims processinginsurance workflowsclaim denialscredentialinginsurance verificationeligibility checksprior authorizationEHR systemsbilling systems

Soft Skills

attention to detailorganizational abilityprofessional communicationcollaborative mindsetindependent managementdeadline management

Certifications

NBI clearanceLocal Police Clearance