credentialing analyst

Chord Specialty Dental Partners

<div><div><b>Location: </b>Nashville, TN or West Chester, PA</div><div><b>
Schedule: </b>Monday - Friday 8:00am - 5:00pm</div><div><b>
Pay: </b>$30 - $35 based on experience</div><div></div><div><br>
At <b>Chord Specialty Dental Partners</b>, exceptional patient care starts with the behind-the-scenes work of our Credentialing team. We&rsquo;re looking for a <b>Credentialing Specialist</b> to join our close-knit, collaborative department that plays a vital role in supporting clinical operations and the revenue cycle.</div><div></div><div><br>
This role involves managing initial and ongoing credentialing, maintaining relationships with insurance payers, and working closely with our Revenue Cycle Management team to resolve claims issues. Organization, adaptability, and strong communication skills are key as you help ensure our providers are always ready to deliver care.</div><div></div><div><br>
Our team is the engine that keeps everything moving&mdash;ensuring our doctors are credentialed and ready to deliver care. Your work directly supports our mission to create healthy, confident, and beautiful smiles every day. If you're detail-oriented and thrive in a fast-paced environment, we&rsquo;d love to have you on our team.</div><div></div><ul><li><div><br>
Onboard new providers and ensure all checklist items are completed and up to date</div></li><li><div>
Manage credentialing with assigned payers, including tracking and follow-up</div></li><li><div>
Enroll providers and offices with State Medicaid agencies and insurance companies</div></li><li><div>
Coordinate new office openings and update payer/internal rosters</div></li><li><div>
Maintain accurate credentialing records</div></li><li><div>
Submit specialty contract requests and upload fee schedules</div></li><li><div>
Complete recredentialing every three years and ensure timely submissions</div></li><li><div>
Review and update payer rosters for accuracy</div></li><li><div>
Communicate credentialing updates and special requests to internal teams</div></li><li><div>
Support the development of SOPs and assist the RCM team with credentialing-related issues</div></li></ul><ul><li><div><br>
3&ndash;5 years of credentialing and enrollment experience required</div></li><li><div>
Proficient in Microsoft Office and credentialing databases</div></li><li><div>
Strong time management, multitasking, and organizational skills</div></li><li><div>
Knowledge of administrative processes and business operations</div></li><li><div>
Excellent written communication, grammar, and proofreading skills</div></li><li><div>
Experience producing professional documents and managing information systems</div></li></ul><div><b>
What We Offer</b></div><div>
We believe that taking care of our employees and their families is paramount. That's why we offer a comprehensive benefits package designed to support you in every aspect of your life. Here&rsquo;s what we provide:</div><ul><li><b>
Medical and Vision Insurance</b>: You're eligible starting the first month after you join.</li><li><b>
In-house Dental Coverage</b>: Enjoy this benefit with $0 premium.</li><li><b>
401(k) Plan with Company Match</b>: We help you plan for your future with our matching program.</li><li><b>
Generous Paid Time Off and Holidays</b>: Take the time you need to relax and recharge.</li><li><b>
Employee Referral Program:</b> Earn rewards for bringing talented individuals to our team.</li><li><b>
Big savings, big perks: </b>Enjoy exclusive discounts on everything from restaurants and travel to movies and more with our employee discount program.</li><li><b>
Pet Insurance</b>: We understand the importance of furry family members too.</li><li><b>
Cutting-edge Technology and Training</b>: We provide the tools and resources you need to excel in your role.</li><li><b>
Life and Disability Insurance Options</b>: Protect yourself and your loved ones with our coverage options.</li></ul><div><b>
Who We Are</b></div><div>
At Chord Specialty Dental Partners, our goal is for every employee to cultivate a fulfilling career. From serving patients in one of our many multi-specialty dental practices to serving our Home Office based out of Nashville, TN- we have something for everyone. We&rsquo;re always looking for talented, driven individuals who have a desire to make an impact.</div><div></div><div><br>
#IND</div></div><div></div>

Senior Credentialing Specialist

Viva Health

<div><p><b>VIVA HEALTH, ranked one of the Best Places to Work by Modern Healthcare, has an exciting opportunity for a Senior Provider Data Analyst position in Birmingham, AL!</b></p>
<p>
The Senior Provider Data Analyst is responsible for supporting and developing VIVA HEALTH&rsquo;S Provider Services initiatives through data analytics, operational reporting, business intelligence and decision support. This role requires highly efficient This position partners with Network Development, Provider Engagement, Credentialing, Value Based Programs, Medical Management, Finance, Information Systems and other business areas to develop reporting, analyze provider and network performance, identify operational improvement opportunities, and support strategic initiatives on department Key Performance Indicator (KPIs).This role requires highly efficient use of data organization and manipulation techniques to produce reporting and provide analytical reasoning on key department indicators relative to standardized benchmarks or norms and company performance goals. This individual will monitor the outcomes of key indicators including health care quality measures, population health outcomes, member experience and surveys, as well as utilization, cost and other operational metrics. The position is responsible for the development, maintenance and presentation of data driven KPI dashboards and other related information and materials to both internal and external audiences.</p>
<p>
REQUIRED:</p>
<ul>
<li>Bachelor&rsquo;s degree in Business, Public Health, Health Care Administration, MIS, HIS, Statistics or related field</li>
<li>Minimum of 3 years&rsquo; experience with data analysis techniques and interpretation</li>
<li>Minimum of 1 year experience working with health care data</li>
<li>Advanced proficiency in Microsoft Excel including Pivot Tables, Power Query, advanced formulas, conditional formatting, lookup functions and data visualization</li>
<li>Intermediate to advanced SQL programming skills with demonstrated experience writing and optimizing complex queries against relational databases</li>
<li>Hands-on experience using Microsoft SQL Server or similar relational database platforms</li>
<li>Demonstrated ability developing dashboards utilizing Tableau, Power BI or similar business intelligence software</li>
<li>Strong understanding of healthcare claims, provider, membership, financial, quality and operational data</li>
<li>Demonstrated ability to organize, manipulate, validate and interpret large, complex healthcare datasets</li>
<li>Strong analytical and critical thinking skills with the ability to independently identify issues and recommend solutions</li>
<li>Demonstrated ability to translate complex analytical findings into concise, actionable recommendations for operational and executive leadership</li>
<li>Excellent written and verbal communication skills</li>
<li>Strong organizational skills with the ability to prioritize multiple projects and competing deadlines</li>
<li>Ability to work independently while collaborating effectively across multidisciplinary teams</li>
<li>Strong attention to detail and commitment to data accuracy</li>
<li>Self-directed with demonstrated initiative and continuous process improvement mindset</li>
</ul>
<p>PREFERRED:</p>
<ul>
<li>Master's degree in a related field (MBA,MHA, MPH or MS in Analytics)</li>
<li>Experience in managed care or health plan analytics, particularly value-based care, provider contracting or Medicare Advantage</li>
<li>Experience supporting executive reporting and strategic planning initiatives</li>
<li>Sigma Six Green Belt or higher</li>
<li>Hands-on experience with Tableau, Power BI, SAS, Crystal Reports or similar reporting and visualization platforms</li>
<li>Knowledge of Medicare Advantage, Commercial Health Plans, provider network operations, value-based care arrangements, accountable care organizations or provider contracting</li>
<li>Familiarity with HEDIS, Stars, CMS reporting, provider quality measures or provider performance measurement</li>
</ul><p>
Equal Opportunity Employer<br>
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.</p></div>

Senior Provider Data Analyst

RCM360

<p><b>About RCM360</b></p><p>RCM360 is a healthcare revenue cycle management organization specializing in medical billing, credentialing, coding, accounts receivable management, and practice optimization services. We partner with healthcare providers across the United States to improve reimbursement, streamline operations, and support long-term financial success.</p><p><b>Position Summary</b></p><p>RCM360 is seeking an experienced and highly organized Provider Enrollment and Credentialing Specialist to support credentialing and enrollment activities for medical providers and healthcare organizations. The Credentialing Specialist will be responsible for managing provider enrollment, recredentialing, payer audits, and maintaining provider data across multiple platforms while ensuring compliance with payer, regulatory, and organizational requirements.</p><p>The ideal candidate will have strong knowledge of Medicare, Medicaid, commercial payer credentialing, and provider enrollment processes, along with the ability to manage multiple projects and deadlines in a fast-paced environment.</p><p><b>Primary Responsibilities</b></p><ul><li>Complete provider credentialing and recredentialing applications for commercial, Medicare, Medicaid, and managed care payers.</li><li>Process provider enrollment, revalidation, and demographic updates with government and commercial payers.</li><li>Maintain accurate provider information in CAQH, PECOS, NPPES, and payer portals.</li><li>Monitor credentialing status and proactively follow up with payers to ensure timely approvals.</li><li>Maintain detailed documentation of credentialing activities within credentialing software and tracking systems.</li><li>Coordinate initial credentialing and ongoing recredentialing with hospitals, surgery centers, and ancillary facilities.</li><li>Verify provider licenses, board certifications, DEA registrations, malpractice insurance, and other required credentials.</li><li>Respond to payer requests for additional documentation and resolve enrollment issues.</li><li>Collaborate with billing, coding, and account management teams to address denials or reimbursement issues related to credentialing.</li><li>Participate in client meetings and provide status updates regarding credentialing projects.</li><li>Stay current with payer guidelines, enrollment requirements, and industry regulations.</li><li>Assist with onboarding new providers and ensure credentialing tasks are completed prior to effective dates.</li><li>Maintain confidentiality and compliance with HIPAA and company policies.</li></ul><p><b>Skills &amp; Abilities</b></p><p><b>General</b></p><ul><li>Excellent written and verbal communication skills.</li><li>Strong attention to detail and organizational abilities.</li><li>Ability to manage multiple provider enrollments simultaneously.</li><li>Professional demeanor with strong customer-service orientation.</li><li>Ability to work independently and as part of a team.</li><li>Proficiency with Microsoft Office applications and credentialing software platforms.</li></ul><p><b>Problem Solving</b></p><ul><li>Identifies and resolves credentialing issues efficiently.</li><li>Research complex payer requirements and enrollment challenges.</li><li>Escalates issues appropriately while maintaining ownership of assigned projects.</li></ul><p><b>Project Management</b></p><ul><li>Tracks multiple credentialing projects and deadlines simultaneously.</li><li>Provides timely updates to clients and internal stakeholders.</li><li>Maintains accurate reporting and documentation.</li></ul><p><b>Preferred Experience</b></p><ul><li>Experience with CAQH, PECOS, NPPES, and Medicare enrollment processes.</li><li>Experience working within a Revenue Cycle Management organization.</li><li>Experience with credentialing software platforms.</li><li>Experience working with offshore teams is a plus.</li><li>Familiarity with eClinicalWorks and NextGen healthcare practice management systems is a plus.</li></ul><p><b>Qualifications</b></p><ul><li><b>Minimum 2 years of medical credentialing experience required.</b></li><li>Demonstrated experience credentialing providers with Medicare, Medicaid, and commercial insurance payers.</li><li>Strong understanding of provider enrollment, recredentialing, and payer maintenance processes.</li><li>High school diploma required</li><li>Credentialing certification (CPCS, CPMSM, or equivalent) preferred but not required.</li></ul><p><b>Job Details</b></p><ul><li>Full-Time</li><li>Remote</li><li>Occasional travel as required for client meetings or training</li></ul><p><b>Key Performance Metrics</b></p><ul><li>Credentialing applications submitted accurately and on time</li><li>Recredentialing projects completed before payer deadlines</li><li>Provider enrollment turnaround times</li><li>Accuracy of provider records and databases</li><li>Client satisfaction and responsiveness</li><li>Productivity and quality standards achieved</li></ul><p>Pay: $45,000.00 - $55,000.00 per year</p><p>Benefits:</p><ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul><p>Work Location: Remote</p>

Provider Enrollment and Credentialing Specialist

biniTelecom

<p>Docs RCM LLC is growing, and we are looking for a dedicated Insurance Credentialing Specialist to join our team!</p><ul><li><b>Position:</b> Insurance Credentialing Specialist</li><li><b>Shift:</b> Night Shift</li><li><b>Location:</b> On-Site</li></ul><p>Key Responsibilities</p><ul><li>Provider Credentialing &amp; Insurance Enrollment</li><li>CAQH Profile Creation, Maintenance &amp; Re-attestation</li><li>Collection and Verification of Provider Documents</li><li>Credentialing Application Preparation &amp; Submission</li><li>Regular Follow-up with Insurance Companies</li><li>Recredentialing &amp; Provider Maintenance</li><li>Management of Payer Portals (Commercial, Medicare &amp; Medicaid)</li><li>Credentialing Status Tracking &amp; Reporting</li><li>Ensuring Compliance with Credentialing Requirements</li><li>Preparing Weekly &amp; Monthly Credentialing Reports</li></ul><p>Requirements</p><ul><li>Minimum 1 year of experience in medical insurance credentialing</li><li>Excellent verbal and written communication skills</li><li>Strong organizational skills with attention to detail</li><li>Ability to work independently and manage multiple credentialing applications</li><li>Willingness to work night shifts</li></ul><p>What We Offer</p><ul><li>Competitive &amp; Lucrative Salary</li><li>Bi-Annual Performance-Based Salary Increments</li><li>Pick &amp; Drop Facility for Female Employees</li><li>Professional, Friendly &amp; Supportive Work Environment</li><li>Career Growth &amp; Learning Opportunities</li></ul><p>If you are passionate about healthcare administration and want to build your career with a fast-growing Revenue Cycle Management company, we would love to hear from you!</p><p>Apply today and become a valued member of the Docs RCM LLC team!</p><p>Pay: Rs60,000.00 - Rs80,000.00 per month</p><p>Work Location: In person</p>

Insurance Credentialing Specialist - Medical Billing - Night Shift

Petroleum Packages Private Limited

<p><b>Position:</b> Credentialing Manager<br/><b>Location:</b> Remote<br/><b>Employment Type:</b> Full-Time</p><p>About EMB<br/>Expert Medical Billing (EMB) is seeking an experienced Credentialing Manager to oversee provider enrollment and credentialing operations for our growing client base. This role is responsible for ensuring providers are properly enrolled, revalidated, and maintained with commercial insurance plans, Medicare, Medicaid, and other payers.<br/>Responsibilities</p><ul><li>Manage the provider credentialing and enrollment process from start to finish.</li><li>Complete new enrollments, revalidations, and demographic updates.</li><li>Maintain provider CAQH profiles and supporting documentation.</li><li>Track credentialing applications and payer follow-up.</li><li>Communicate with providers, clients, and payer representatives.</li><li>Maintain credentialing databases and status reports.</li><li>Ensure compliance with payer and regulatory requirements.</li><li>Supervise credentialing staff and assist with process improvements.</li></ul><p>Qualifications</p><ul><li>Minimum 3 years of provider credentialing experience.</li><li>Strong knowledge of Medicare, Medicaid, and commercial payer enrollment.</li><li>Experience with CAQH, PECOS, NPPES, and payer portals.</li><li>Excellent organizational and communication skills.</li><li>Ability to manage multiple projects and meet deadlines.</li><li>Leadership experience is preferred.</li></ul><p>What We're Looking For</p><ul><li>Highly organized and detail-oriented.</li><li>Strong problem-solving skills.</li><li>Ability to work independently and lead a remote team.</li><li>Commitment to providing exceptional client service.</li></ul><p><b>Other duties, projects, and responsibilities may be assigned as necessary to support EMB's continued growth and operational needs.</b></p><p>Work Location: Remote</p>

Credentialing Manager

Positive Behavior Supports

<div></div><div><p><b>Entry Level Behavior Assistant and Experienced Registered Behavior Technicians (RBT)</b><b> Roles!</b></p>
<p><i>
***Part-time positions available with the opportunity to grow into full-time as caseloads expand***</i></p>
<p><i>
</i></p><p><b>Why Join PBS?</b>
</p><p>PBS offers mentoring and advancement opportunities for those with career aspirations working with special needs children! As a Behavior Assistant (BA), you can enroll in our complimentary training to become a Registered Behavior Technician (RBT), as well as Student Analysts (SA) roles if a career as a Board Certified Behavior Analyst (BCBA) is in your future!!! Founded in 2007, PBS is a dedicated ABA provider committed to helping children with autism thrive in their homes, schools and community. We value our entry level team members through a <b>supportive, flexible, and growth-focused</b> work environment. PBS believes in training the future of our field to ensure we are providing the best quality services to families in need!</p>
<p><i>
*All roles are subject to local and state requirements related to licensure, credentialing and certification*</i></p>
<p>
</p><p><b>The PBS Mission:</b>
</p><p></p><ul><li>Create a responsive system that applies the principles of PBS to meet the needs of individuals, families and organizations we serve to produce quality of life changes that last
</li><li>Develop an organization that attracts the most competent, enthusiastic people and turns them into proficient professionals
</li></ul><div></div><p><b>What We Offer:</b>
</p><div></div><p>✅ <b>Flexible Scheduling</b> - Work-life balance is a priority
</p><div></div><p>✅ <b>Competitive Pay</b> - Annual Raises
</p><div></div><p>✅ <b>Quarterly Bonus</b> - $500 (for those averaging 25 hours a week for the entire quarter)
</p><div></div><p>✅ <b>Holiday Pay-</b> Time and a half for working on identified PBS holidays
</p><div></div><p>✅<b> Career Growth Pathway</b>s - Advance from Behavior Assistant to an RBT!
</p><div></div><p>✅ <b>Complimentary 40 Hour RBT Training</b>
</p><div></div><p>✅ <b>Paid Travel &amp; Mileage Reimbursement</b> (if applicable)
</p><div></div><p>✅ <b>Medical, Dental, Vision Insurance</b> (30+ hours per week)
</p><div></div><p>✅<b> Paid Sick Time</b>- Based on state requirements
</p><div></div><p>✅ <b>Retirement</b>- 401(k) with Company Match Up to 3%
</p><p></p><p><b>Job Responsibilities:</b>
</p><div></div><p>✅ Work 1:1 with children with autism using ABA strategies under the supervision of a BCBA
</p><div></div><p>✅ Implement individualized treatment plans designed and trained by a BCBA
</p><div></div><p>✅ Collect &amp; record data to track client progress using PBS tracking tools
</p><div></div><p>✅ Communicate with families &amp; clinical teams to ensure client success
</p><div></div><p>✅ Attend scheduled supervisions, team meetings &amp; ongoing training
</p><p></p><p><b>Requirements:</b>
</p><div></div><p>✅ High school diploma (Bachelor's in Psychology, Education, or related field a plus)
</p><div></div><p>✅ Reliable transportation &amp; willingness to travel locally (if required)
</p><div></div><p>✅ Ability to actively engage clients during sessions, go from sitting to standing unassisted and lift 50lbs
</p><div></div><p>✅ Experience in ABA therapy, childcare, education, or related field a plus!
</p><div></div><p>✅ Ability to actively engage with clients, sit on the floor, go from sitting to standing unassisted and lift up to 50lbs
</p><p></p><p><b>Ready to Make a Difference? Apply Today!</b></p></div>

Behavior Assistant with Team PBS in Michigan

Lighthouse Psychiatry Brain Health Center

<div>
 <strong>
  Virtual Assistant (VA) &ndash; Medical Billing / Credentialing (Psychiatry).
  <br/>
  <br/>
 </strong>
 <strong>
  Company:
 </strong>
 <strong>
  Lighthouse Psychiatry | Arizona.
  <br/>
  <br/>
 </strong>
 <strong>
  Location:
 </strong>
 Remote (US, Philippines, Vietnam, India, Mexico).
 <br/>
 <br/>
 <strong>
  Job Type:
 </strong>
 Full-time / Part-time (Night Shift / U.S. Business Hours).
 <br/>
 <br/>
 <strong>
  Industry:
 </strong>
 Healthcare / Medical Billing / Behavioral Health.
 <br/>
 <br/>
 <strong>
  Hire Model:
 </strong>
 Direct hire (Contract).
 <br/>
 <br/>
 <strong>
  Pay:
 </strong>
 Based on level of experience (opportunity for growth).
 <br/>
 <br/>
 <strong>
  Position Summary
  <br/>
  <br/>
 </strong>
 Lighthouse Psychiatry is seeking a highly organized Medical Billing &amp; Credentialing Specialist responsible for managing the revenue cycle from patient eligibility through claim resolution while ensuring providers remain properly credentialed with commercial and government payers. This role is essential to maximizing reimbursement, maintaining payer compliance, and supporting the growth of our outpatient psychiatry, TMS, Spravato, IV ketamine, and psychotherapy programs.
 <br/>
 <br/>
 The ideal candidate has experience with psychiatric billing, athenaOne, insurance credentialing, and payer relations, with the ability to work independently while maintaining exceptional attention to detail.
 <br/>
 <br/>
 <strong>
  Primary Medical Billing &amp; Revenue Cycle Responsibilities
  <br/>
  <br/>
 </strong>
 <strong>
  Patient Registration &amp; Front-End Revenue Cycle:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Verify insurance eligibility and benefits.
  </li>
  <li>
   Update insurance information and demographics.
  </li>
  <li>
   Review appointment schedules for insurance issues.
  </li>
  <li>
   Identify authorization requirements.
  </li>
  <li>
   Resolve registration and eligibility errors.
  </li>
  <li>
   Manage insurance verification work queues.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Charge Capture
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Review encounters for billing completeness.
  </li>
  <li>
   Enter charges accurately.
  </li>
  <li>
   Validate CPT and ICD-10 coding consistency.
  </li>
  <li>
   Identify missing documentation.
  </li>
  <li>
   Process no-show billing when applicable.
  </li>
  <li>
   Upload supporting documentation.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Claims Management
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Submit electronic claims.
  </li>
  <li>
   Correct claim edits.
  </li>
  <li>
   Monitor claim acceptance.
  </li>
  <li>
   Review claim history.
  </li>
  <li>
   Submit corrected claims.
  </li>
  <li>
   Process secondary claims.
  </li>
  <li>
   Coordinate benefits (COB).
  </li>
  <li>
   Monitor telehealth claims.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Accounts Receivable
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Follow up on unpaid claims.
  </li>
  <li>
   Investigate denied claims.
  </li>
  <li>
   Resolve payer edits.
  </li>
  <li>
   Prepare appeals.
  </li>
  <li>
   Monitor aging reports.
  </li>
  <li>
   Review payment variances.
  </li>
  <li>
   Research patient accounts.
  </li>
  <li>
   Process insurance corrections.
  </li>
  <li>
   Manage collection worklists.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Payment Posting
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Post insurance payments.
  </li>
  <li>
   Post patient payments.
  </li>
  <li>
   Process credit card transactions.
  </li>
  <li>
   Interpret EOBs and ERAs.
  </li>
  <li>
   Resolve payment discrepancies.
  </li>
  <li>
   Review credit balances.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Specialty Psychiatry Billing
  <br/>
  <br/>
 </strong>
 Independently manage billing for:
 <br/>
 <br/>
 <ul>
  <li>
   Medication Management.
  </li>
  <li>
   Psychiatric Evaluations (90791/90792).
  </li>
  <li>
   Psychotherapy.
  </li>
  <li>
   Add-on psychotherapy codes.
  </li>
  <li>
   Telepsychiatry.
  </li>
  <li>
   TMS.
  </li>
  <li>
   Spravato.
  </li>
  <li>
   IV Ketamine.
  </li>
  <li>
   Urine Drug Screening.
  </li>
  <li>
   Prior Authorizations.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Credentialing Responsibilities (if Applicable)
  <br/>
  <br/>
 </strong>
 Manage the credentialing lifecycle for psychiatrists, psychiatric nurse practitioners, psychologists, therapists, and other clinical staff.
 <br/>
 <br/>
 <strong>
  Responsibilities Include
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Complete initial payer enrollment applications.
  </li>
  <li>
   Process provider recredentialing.
  </li>
  <li>
   Maintain CAQH profiles.
  </li>
  <li>
   Track provider license expiration.
  </li>
  <li>
   Monitor DEA registrations.
  </li>
  <li>
   Track board certifications.
  </li>
  <li>
   Monitor malpractice insurance expiration.
  </li>
  <li>
   Maintain provider credentialing files.
  </li>
  <li>
   Submit supporting documentation.
  </li>
  <li>
   Communicate with insurance companies.
  </li>
  <li>
   Track credentialing status.
  </li>
  <li>
   Maintain provider rosters.
  </li>
  <li>
   Complete demographic updates.
  </li>
  <li>
   Assist with new provider onboarding.
  </li>
  <li>
   Ensure compliance with payer requirements.
  </li>
  <li>
   Monitor participation status.
  </li>
  <li>
   Maintain provider directories.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Required Knowledge
  <br/>
  <br/>
 </strong>
 Strong understanding of:
 <br/>
 <br/>
 <ul>
  <li>
   CPT coding.
  </li>
  <li>
   ICD-10 diagnosis coding.
  </li>
  <li>
   Medical terminology.
  </li>
  <li>
   HIPAA regulations.
  </li>
  <li>
   EOB interpretation.
  </li>
  <li>
   Revenue Cycle Management.
  </li>
  <li>
   Insurance eligibility.
  </li>
  <li>
   Claim adjudication.
  </li>
  <li>
   Prior authorization requirements.
  </li>
  <li>
   Coordination of Benefits (COB).
  </li>
  <li>
   Medicare billing.
  </li>
  <li>
   AHCCCS billing.
  </li>
  <li>
   Commercial insurance billing.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Qualifications
  <br/>
  <br/>
 </strong>
 <strong>
  Required:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   2+ years of medical billing experience.
  </li>
  <li>
   1+ year of insurance credentialing experience.
  </li>
  <li>
   Experience with commercial insurance and Medicare.
  </li>
  <li>
   Strong computer proficiency.
  </li>
  <li>
   Excellent organizational skills.
  </li>
  <li>
   Ability to manage multiple deadlines.
  </li>
  <li>
   Strong written and verbal communication.
  </li>
  <li>
   Clean claim rate high.
  </li>
  <li>
   First-pass claim acceptance rate high.
  </li>
  <li>
   Payment posting accuracy.
  </li>
  <li>
   Work queue completion rate high.
  </li>
  <li>
   Productivity standards high.
  </li>
  <li>
   Documentation accuracy high.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Behavioral health or psychiatry billing experience.
  </li>
  <li>
   athenaOne experience.
  </li>
  <li>
   AHCCCS experience.
  </li>
  <li>
   CPC, CPB, or equivalent certification.
  </li>
  <li>
   Credentialing experience with multi-provider practices.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Ideal Candidate
  <br/>
  <br/>
 </strong>
 The ideal candidate is detail-oriented, analytical, and proactive, with the ability to independently manage both revenue cycle operations and provider credentialing. They thrive in a fast-paced outpatient behavioral health environment and are committed to improving reimbursement, reducing denials, and ensuring uninterrupted payer participation for providers.
 <br/>
 <br/>
 This job description aligns closely with the competency framework in your Billing Skills Tracker while converting it into a market-ready hiring document suitable for Indeed, LinkedIn, or internal HR use. It is particularly tailored for an Arizona psychiatry practice using athenaOne and managing commercial insurance, Medicare, and AHCCCS.
 <br/>
 <br/>
 <strong>
  Keywords
  <br/>
  <br/>
 </strong>
 Virtual Assistant, Healthcare Virtual Assistant, Medical Billing VA, Insurance Verification VA, Prior Authorization VA, Telehealth VA, Revenue Cycle Assistant, Medical Billing, Claims Processing, Insurance Verification, Prior Authorization, Revenue Cycle Management (RCM), Denial Management, EOB Reconciliation, Patient Intake, Appointment Scheduling, Data Entry, HIPAA Compliance, EMR/HER, CPT Codes, ICD-10, HCPCS, Claims Submission, Eligibility Checking, Payer Portals, Medical Coding, Billing Software, Athena, DrChrono, Kareo, AdvancedMD, Epic, Practice Fusion, Behavioral Health, Psychiatry, Mental Health, Telemedicine, Telehealth, Healthcare Administration, Patient Access, Front-End Billing, Back-End Billing, Remote, Philippines, Night Shift, Offshore Healthcare, Home-Based, Virtual Office.
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Virtual Assistant - Medical Billing/Credentialing

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