Job Summary
We are looking for an experienced Medical Billing and Credentialing Specialist to support our growing client portfolio. You will work as part of a highly skilled and versatile team, working together on the full billing cycle, as well as working as one of our primary credentialing and recredentialing specialists.
Duties
- Prepare, submit, and track medical claims through EHR systems and billing platforms; promptly follow up on unpaid, denied, or rejected claims
- Manage provider credentialing and re-credentialing across commercial, government, and behavioral health carve-out payers — including CAQH profile maintenance and payer panel enrollment
- Monitor credentialing timelines and proactively communicate status updates to providers and internal stakeholders
- Review clinical documentation for completeness, coding accuracy, and compliance with payer-specific requirements
- Identify billing discrepancies, coordinate resolution, and escalate complex claim issues as appropriate
- Maintain meticulous records of billing activity, credentialing statuses, payer correspondence, and provider documentation
- Support HIPAA-compliant handling of patient account inquiries and billing communications
- Stay current on payer policy changes, coding updates (CPT, ICD-10), and behavioral health billing regulations
Qualifications
Required:
- Minimum 2 years of experience in medical billing and/or credentialing in a professional healthcare setting
- Working knowledge of EHR platforms and practice management software (e.g., SimplePractice, Jane App, Charm EHR, or similar)
- Solid understanding of CPT and ICD-10 coding, claim submission workflows, and ERA/EOB reconciliation
- Familiarity with CAQH, PECOS, and commercial payer credentialing portals
- Strong attention to detail and ability to manage multiple providers and deadlines simultaneously
- Excellent written communication skills for professional payer and provider correspondence
- Commitment to HIPAA compliance and patient privacy standards
Preferred:
- Experience billing for behavioral health, psychiatry, or mental health services — including knowledge of behavioral health carve-out payers and parity compliance considerations
- Experience credentialing with behavioral health-specific payers (e.g., Optum/UBH, Magellan, Beacon Health Options)
- CPC, CPMA, CPCO, or CBCS certification is a plus
What We Offer
- Fully remote position with flexible scheduling
- A collaborative, small-team environment where your expertise is recognized and valued
- Exposure to a diverse and growing client base across behavioral health and general medicine
- Opportunities to contribute to process development and compliance documentation
Pay: $19.50 - $22.50 per hour
Work Location: Remote
