U.s. healthcare rcm / billing / credentialing / prior authorization specialist

Breakthru AI is a U. S.-based healthcare administration company supporting medical clinics across the United States. We help clinics streamline revenue cycle and administrative operations, including medical billing, accounts receivable follow-up, credentialing, prior authorizations, referrals, and patient access support.

We are hiring experienced U. S. healthcare professionals to join our growing remote team.

Candidates may specialize in one or more of the following areas:

Medical Billing / RCM Credentialing / Provider Enrollment Prior Authorization / Referral Coordination

Responsibilities may include:

Charge entry and claim submission Payment posting, ERA/EOB review, and manual posting Accounts receivable follow-up and denial management Insurance eligibility and benefits verification Prior authorization submission and follow-up Referral coordination and documentation follow-up Provider credentialing, CAQH maintenance, payer enrollment, and recredentialing

Requirements:

Real experience working in U. S. healthcare operations Experience with Medicare, Medicaid, and commercial insurance Familiarity with clearinghouses, payer portals, and EHR/PM systems

Preferred experience:

Primary Care / Family Medicine Internal Medicine Surgery / Orthopedics / Pain Management Mental Health / Psychiatry Home Health Agencies FQHC / Community Health Centers Allergy / Cardiology / Nephrology e Clinical Works, Athena, Advanced MD, Office Ally, Kareo, Dr Chrono, Waystar, Availity, Change Healthcare, Cover My Meds, CAQH, PECOS, NPPES, and payer portals

Important:

Only candidates with real U. S. healthcare billing, credentialing, prior authorization, or revenue-cycle experience will be considered.