Reimbursement & Credentialing Specialist

Emergicon•Terrell, TX

13d•Remote

About The Position

Emergicon is hiring a Reimbursement & Credentialing Specialist to ensure client agencies are enrolled with health insurance payers, including Medicare, Medicaid, and commercial plans. The role handles enrollment and re-enrollment applications, electronic payment setup, payer portals, provider group accounts, and maintenance of provider licenses and insurance addresses. It also includes completing W-9 forms, interpreting payer documents, resolving issues, and providing service to clients and payers. The position reports to the Credentialing & Reimbursement Lead. The role is based in Terrell, Texas, and requires the employee to be a Texas resident. The posting describes hands-on training during the first 90 days and remote work during that period. Offers are contingent on passing a pre-employment background check and drug screening.

Requirements

High school diploma.
At least 2 years of provider enrollment experience.
Ability to explain the difference between EFT, ERA, EOB, COB, and a “pay to” address.
Ability to read payer applications and understand how payers work.
Knowledge of federal and state insurance laws.
Knowledge of insurance claim processing and third-party reimbursement.
Ability to prioritize work and meet tight deadlines.
Clear, respectful communication.
Must be a Texas resident for consideration.

Responsibilities

Prepare enrollment and re-enrollment applications for all health plans, including Medicare and Medicaid.
Set up payer portals for eligibility, claim filing, claim status, ERA, EFT, and appeals.
Set up and maintain group accounts for multiple providers.
Keep provider licenses and insurance addresses up to date.
Complete and send W-9 forms.
Read and interpret complex payer documents.
Solve problems and provide service to clients and payers.
Meet deadlines in a fast-paced environment.
Live out Emergicon’s core values.
Perform other duties as assigned.