Benefits:
• Employee discounts
• Medical Billing Specialist Complex Cases & Credentialing Remote | Full-Time or Contract
About the Role
We are seeking a highly experienced Medical Billing Specialist with a strong background in complex billing environments. This is not an entry-level position we need a true specialist who can hit the ground running with minimal oversight. While this role is remote, it requires a hands-on, engaged work style with consistent availability and accountability.
Key Responsibilities
• Manage end-to-end medical billing and claims submission using eClinicalWorks (eCW) and TriZetto (Facets/Gateway)
• * Handle credentialing for providers across multiple tax IDs and EIN structures
• * Work complex billing cases involving dual or multi-entity practice configurations
• * Submit, track, and follow up on claims across multiple payers and insurance networks
• * Identify and resolve claim denials, rejections, and underpayments
• * Maintain accurate records and ensure compliance with payer-specific billing requirements
• * Coordinate with insurance carriers, clearinghouses, and internal staff as needed
• Required Qualifications
• Minimum 5 years of hands-on medical billing experience complex cases required
• * Proficiency in eClinicalWorks billing module (not just scheduling or front-desk use)
• * Direct experience with TriZetto as a clearinghouse or payer platform
• * Demonstrated experience managing billing across multiple tax IDs and/or EINs
• * Strong knowledge of provider credentialing processes
• * Ability to work independently, manage multiple priorities, and meet deadlines
• * Excellent attention to detail and strong communication skills
• Preferred Qualifications
• CPC, CPB, or similar billing/coding certification
• * Experience with specialty practices (vein, aesthetics, surgical, or similar)
• * Familiarity with multi-provider or multi-entity practice structures
• Please do not apply if you do not have direct, verifiable experience in complex medical billing with eClinicalWorks and TriZetto. Experience is non-negotiable for this role.
This is a remote position.