Claim Denial Management & Insurance Credentialor

We are seeking a highly organized and detail-oriented Virtual Assistant based in the Philippines to support our billing department. The ideal candidate will manage insurance claim denials and oversee the credentialing process for providers. Experience in U.S.-based healthcare systems, particularly behavioral health or mental health, is preferred.


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Key Responsibilities

Claim Denial Management:

Review denied insurance claims and identify root causes.

Submit appeals and corrected claims to payers in a timely manner.
Insurance Credentialing:

Complete and submit provider enrollment and revalidation applications.

Track credentialing and re-credentialing deadlines to ensure timely submission.

Maintain a credentialing database with provider information and insurance panel statuses.

Follow up with insurance payers regularly on the status of credentialing applications.

Assist in gathering required documentation from providers.
Qualifications
Proven experience in medical billing, insurance claims processing, or credentialing (minimum 1 year preferred)

Familiarity with U.S. insurance companies and payer portals (e.g., Availity, CAQH, etc.)

Excellent English communication skills (written and verbal)

Strong organizational and time-management skills

Proficiency in Microsoft Office, Google Workspace, and practice management systems

Ability to work independently with minimal supervision

Fast, reliable internet connection and a quiet work environment