credentialing manager

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

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

Redwood Orthopaedic Surgery Associates, AMC

<p>Part-Time Administrative Assistant (20 Hours per Week)</p><p>Position Summary</p><p>The Part-Time Administrative Assistant (20 hours per week) provides administrative, operational, and marketing support to ensure the efficient day-to-day functioning of the practice. This position assists with credentialing, human resources administration, accounts payable, marketing initiatives, and general office operations while maintaining a high level of organization, accuracy, and professionalism.</p><p>Essential Duties and Responsibilities</p><p>Credentialing &amp; Provider Support</p><ul><li>Assist with provider credentialing and payer contracting follow-up.</li><li>Maintain and update provider information in CAQH.</li><li>Track credentialing and contracting deadlines and documentation.</li></ul><p>Human Resources Support</p><ul><li>Assist with ADP HR maintenance and employee record updates.</li><li>Coordinate and assign required employee compliance and training modules.</li><li>Support HR administrative functions as assigned.</li></ul><p>Accounting &amp; Financial Support</p><ul><li>Process accounts payable by paying vendor invoices in a timely manner.</li><li>Enter invoices and financial data into QuickBooks Online (QBO).</li><li>Assist with financial record organization and invoice processing as assigned.</li></ul><p>Administrative Support</p><ul><li>Open and distribute incoming mail.</li><li>Scan, organize, and electronically file documents.</li><li>Maintain organized electronic and paper filing systems.</li><li>Provide general administrative support to leadership as needed.</li></ul><p>Marketing Support</p><ul><li>Assist with marketing coordination and execution.</li><li>Maintain the practice marketing calendar in collaboration with the Clinical Manager.</li><li>Assist with social media content, newsletters, and marketing communications as assigned.</li><li>Coordinate marketing events and community outreach logistics.</li></ul><p>Staff Engagement &amp; Meeting Support</p><ul><li>Coordinate staff appreciation events, birthdays, celebrations, and employee recognition programs.</li><li>Record and distribute meeting minutes for staff and leadership meetings.</li><li>Assist with planning internal meetings and special events.</li></ul><p>Qualifications</p><ul><li>Excellent organizational and time management skills.</li><li>Strong attention to detail and ability to manage multiple priorities.</li><li>Proficient with Microsoft Office and Google Workspace.</li><li>Experience with QuickBooks Online (QBO) preferred.</li><li>Experience with ADP HR systems preferred.</li><li>Experience with healthcare credentialing and CAQH preferred.</li><li>Strong written and verbal communication skills.</li><li>Ability to maintain confidentiality and exercise professionalism at all times.</li></ul><p>Pay: $25.99 - $31.30 per hour</p><p>Benefits:</p><ul><li>Flexible schedule</li></ul><p>Work Location: Hybrid remote in Santa Rosa, CA 95403</p>

Administrative Assistant

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

University of Minnesota

<div><p>Required Qualifications:</p><ul><li>
Bachelor&rsquo;s degree; or combination of related education and experience as project coordinator and/or project management to equal 4 years.</li><li>
Demonstrated experience in working within learning management systems, such as Canvas, Storyline Articulate, and Parchment.</li><li>
A technical background and experience with user-centered design including accessibility; software user experience (project management, eLearning authoring, data quality for reporting, graphic design, multimedia development, operating systems, etc.).</li><li>
Experience in developing user facing documentation such as forms, videos, and guides.</li><li>
Familiar with Google office suite, shared folders, and documents.</li></ul><p>
Preferred Qualifications:</p><ul><li>
Bachelor&rsquo;s degree in education, social work, or family social science fields</li><li>
Experience at the University of Minnesota in any of the following systems/units: Curriculum Management, Canvas, Communications, or IT support.</li><li>
Experience managing projects from proposal through completion.</li><li>
Experience in a K-12 school setting, and/or human development setting.</li><li>
Understanding and ability to articulate project management phases, tools and techniques.</li><li>
Understanding of Agile Development methodologies and processes</li></ul><p>
Position Overview</p><p>
University of Minnesota&rsquo;s College of Education and Human Development, Office of Lifelong Learning &amp; Credentialing is a dynamic, collaborative team that creates online professional development opportunities with department subject matter experts (SME&rsquo;s) and faculty members inside the College of Education and Human Development, as well as clients both across and outside of the University. CEHD recently established the Office of Lifelong Learning &amp; Credentialing to meet the growing interest and demand for continuing lifelong learning and credentialing for adult learners, alumni, and practitioners. This new initiative focuses on creating impactful, inclusive, and accessible training opportunities to meet the needs of the many MN workers and agencies.<br>
<br>
The instructional designer coordinates with working groups across multiple units and departments within CEHD, ensuring we are building innovative, inclusive, and rigorous professional development learning opportunities within the University of Minnesota&rsquo;s learning management system, utilizing Canvas and Destiny One Registration System (DORS). This position serves as project lead for the projects they are assigned, and will provide support for non-credit courses and certificate programs being developed using adult learner and instructional design best practices; and assists with Destiny One Registration System (DORS) integration and registration. The Instructional Designer works with the OLLC Director and Project Manager to assist in formulating and defining project scope and objectives, research user needs, and partner with multiple stakeholders to move projects through the development stages to guide projects to launch and completion. This position will manage all alternative credentialing requests and creation, ensuring CEHD and University policies and procedures are followed.<br>
<br>
A successful candidate for this position is familiar with online learning platforms/resources with the ability to utilize learning management systems for course design and creation, registration, and report tracking. This candidate has experience with leading projects and can coordinate projects with a proven track record of success, including examples of how they managed timelines and stakeholders; prioritize work and shared accountability for outcomes across multiple projects; thrive in an organization with a variety of stakeholders; and be motivated to develop and refine processes.<br>
<br>
The University of Minnesota encourages a healthy work life balance for employees. CEHD is committed to an excellent employee experience, offering a flexible work environment that meets the needs of students, staff, faculty, and the communities we serve. Flexible work arrangements may include flexibility in schedule and/or work location. All UMN employees are expected to follow applicable public health and safety procedures.</p><p><i>
Please note, this position is not eligible for H-1B or Green Card sponsorship. This position does not offer a STEM OPT training program.</i><br>
<br>
Job Responsibilities</p><p>
70% LMS Systems &amp; Instructional Design, Non-credit</p><ul><li>
Collaborate with College of Education and Human Development (CEHD) department/unit contacts in creating/designing new non-credit professional development, course content and course design.</li><li>
Maintain existing courses. Modify course information (including logistics, cohorts and content), document updates, and ensure trainers are aware of any changes<ul><li>
Create Canvas courses following adult learner best practices and ADA accessibility</li><li>
Manage course documentation</li><li>
Communicate with OLLC team on Canvas course template progress and documentation</li><li>
Set goals and expectations for course delivery</li><li>
Create and modify Canvas course templates for future course builds, utilizing branding elements for specific projects</li></ul></li><li>
Assist with the Destiny One registration system for current and future course offerings</li><li>
Pull reports and analytics when needed across multiple Learning Management Systems</li><li>
Collaborate across teams by attending weekly meetings and provide updates to multiple working groups</li><li>
Manage new course requests for OLLC team, in collaboration with the Director team and project manager</li><li>
Work with SME&rsquo;s in gathering all necessary information and content to create an online learning course</li><li>
Coordinate with Project manager in creating project timelines, set goals, and provide project updates on a biweekly basis</li></ul><p>
20% Manage CEHD Alternative Credentials</p><ul><li>
Serve as primary contact for all CEHD alternative credential requests; such as CEUs, clock hour certificate, digital badges, and state licensing board requirements.</li><li>
Manage request for alternative credentials for the college</li><li>
Liason with the MN department of education in securing approved administrative level CEUs.</li><li>
Manage CEHD clock hour certificate approval process.</li></ul><p>
10% User Experience &amp; Quality Assurance Lead</p><ul><li>
Leads training and onboarding of LMS system with new OLLC staff and trainers</li><li>
Design learner-facing process documents, FAQ articles, and video tutorials following UX and accessibility standards</li><li>
Research, develop and implement new LMS processes with OLLC staff</li></ul><p>
ABOUT CEHD</p><p>
About OLLC:</p><p>
The Office of Lifelong Learning and Credentialing (OLLC) is a service unit within CEHD, housed under the Office of Graduate and Professional Education. OLLC provides oversight, guidance, and subject-matter expertise related to non-credit professional development, alternative credentialing, and lifelong learning systems and processes. OLLC ensures that all non-credit professional development and alternative credentialing requests are reviewed, approved, and implemented using consistent CEHD standards related to program design, credentialing rigor, course structure, and the overall look and feel of offerings.<br>
<br>
Through this centralized approach, OLLC promotes equity, consistency, and transparency across CEHD by ensuring that all learners receive high-quality, CEHD-approved credentials regardless of the unit, department, or center delivering the program.<br>
<br>
About the College:</p><p>
The College of Education and Human Development (CEHD), the third largest college and the University, contributes to a just and sustainable future through engagement with the local and global communities to enhance human learning and development at all stages of the life span. We know diversity is necessary to do our best work and foster our humanity. That&rsquo;s why the CEHD community is collectively dedicated to cultivating an inclusive and equitable environment, embracing and celebrating all identities of our students, staff, and faculty. These values are also a moral imperative requiring continuous proactive measures and a firm stance against prejudice, discrimination, and systemic injustice</p><p>
Applications must be submitted online. To be considered for this position, please click the Apply button and follow the instructions. You will be given the opportunity to complete an online application for the position and attach a cover letter and resume.</p><p>
Required Application Materials:</p><ul><li>
Resume</li><li>
Cover Letter</li></ul><p>
Additional documents may be attached after application by accessing your &quot;My Job Applications&quot; page and uploading documents in the &quot;My Cover Letters and Attachments&quot; section.</p><p>
To request an accommodation during the application process, please e-mail employ@umn.edu or call (612) 624-8647.</p><p>
The University recognizes and values the importance of diversity and inclusion in enriching the employment experience of its employees and in supporting the academic mission. The University is committed to attracting and retaining employees with varying identities and backgrounds.</p><p>
The University of Minnesota provides equal access to and opportunity in its programs, facilities, and employment without regard to race, color, creed, religion, national origin, gender, age, marital status, disability, public assistance status, veteran status, sexual orientation, gender identity, or gender expression. To learn more about diversity at the U: http://diversity.umn.edu</p><p>
Any offer of employment is contingent upon the successful completion of a background check. Our presumption is that prospective employees are eligible to work here. Criminal convictions do not automatically disqualify finalists from employment.</p><p></p><p>
The University of Minnesota, Twin Cities (UMTC)</p><p>
The University of Minnesota, Twin Cities (UMTC), is among the largest public research universities in the country, offering undergraduate, graduate, and professional students a multitude of opportunities for study and research. Located at the heart of one of the nation's most vibrant, diverse metropolitan communities, students on the campuses in Minneapolis and St. Paul benefit from extensive partnerships with world-renowned health centers, international corporations, government agencies, and arts, nonprofit, and public service organizations.</p><p>
At the University of Minnesota, we are proud to be recognized by Forbes as a Best Employer for Company Culture (2026), Best Employer for Women (2023), and Best Employer by State (2022-2026). In 2026, we also received Culture Excellence &amp; Industry Awards recognition for employee appreciation and work-life flexibility.</p></div>

LMS Instructional Design

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.
</div>


Virtual Assistant - Medical Billing/Credentialing

Search 4771+ Credentialing manager jobs near you this August. New roles added regularly across leading industries. Apply today.