Our partner is looking for a Medical Insurance Credentialing Specialist based in Spain. We are seeking a detail-oriented Medical Insurance Credentialing Specialist to manage provider enrollment, credentialing, and medical billing operations in a remote healthcare environment. In this role, you will coordinate with insurance payers, healthcare providers, and internal teams to ensure accurate documentation, timely claims processing, and reliable reimbursement. You will oversee credentialing applications and renewals while maintaining compliance with payer requirements and applicable healthcare regulations. Your expertise in insurance billing, coding, and claims resolution will help minimize denials and prevent delays in provider network participation. You will also monitor payment discrepancies, maintain comprehensive records, and identify opportunities to improve revenue cycle processes. This is an opportunity to contribute to efficient healthcare administration while supporting providers and delivering operational accuracy. Accountabilities:



* Prepare and submit credentialing applications for new healthcare providers across commercial insurance carriers, Medicare, Medicaid, and managed care organizations. * Manage provider re-credentialing within required timelines to prevent lapses in insurance network participation. * Maintain accurate provider information in credentialing databases, payer portals, and related systems. * Coordinate with providers to collect required documentation, professional licenses, certifications, and signatures. * Review, prepare, and submit medical insurance claims accurately using electronic health record (EHR) and billing systems. * Apply appropriate CPT, HCPCS, and ICD-10 codes, including relevant modifiers, in accordance with applicable billing guidelines. * Verify patient demographics, insurance eligibility, and coverage details before submitting claims. * Apply payer-specific policies, fee schedules, and filing deadlines to support ac

📌 Medical Insurance Credentialing Specialist (Santander)
🏢 Jobgether
📍 Santander