What are the responsibilities and job description for the Billing and Credentialing Specialist position at Recovery and Wellness Center of Eastern Washington?
Position Summary
The Billing & Credentialing Specialist is responsible for overseeing the organization’s revenue cycle by ensuring accurate insurance billing, provider credentialing, claims management, and payer compliance. This role is essential in maintaining organizational cash flow, supporting providers, and ensuring compliance with federal, state, and insurance requirements.
The ideal candidate is highly organized, detail-oriented, experienced in behavioral health billing, and enjoys improving systems and workflows in a growing organization.
Essential Duties & Responsibilities
Billing & Revenue Cycle
- Submit electronic claims accurately and in a timely manner
- Review claims for completeness and accuracy prior to submission
- Monitor claim status and resolve rejected, denied, or unpaid claims
- Submit corrected claims and manage appeals processes
- Post insurance and patient payments
- Verify insurance eligibility and benefits
- Monitor aging accounts receivable and generate billing reports
- Collaborate with providers to resolve documentation or coding issues
- Maintain up-to-date knowledge of payer rules and billing requirements
Credentialing & Provider Enrollment
- Complete initial credentialing and re-credentialing for providers
- Maintain CAQH profiles and ensure accuracy
- Enroll providers with commercial insurance, Medicaid, Medicare, and other payers
- Track provider licenses, NPIs, DEAs, certifications, and insurance requirements
- Maintain credentialing files and documentation
- Communicate directly with insurance companies and payer representatives
Compliance & Documentation
- Maintain HIPAA compliance at all times
- Stay current on billing regulations and payer requirements
- Assist with audits as needed
- Ensure accurate documentation within the EHR system
Administrative Support
- Collaborate closely with leadership and clinical teams
- Assist in development and refinement of billing policies and procedures
- Recommend workflow and system improvements
- Participate in staff and leadership meetings
- Perform other duties as assigned
Preferred Qualifications
- Minimum 2 years of medical billing experience (behavioral health preferred)
- Experience with provider credentialing and payer enrollment
- Knowledge of Medicaid, Medicare, and commercial insurance billing
- Experience with CPT, HCPCS, ICD-10, and modifiers
- Experience using EHR systems and billing platforms
- Strong organizational, communication, and Microsoft Office skills
Preferred Experience
Experience billing for services such as:
Individual Therapy, Group Therapy, Family Therapy, Substance Use Disorder Treatment, Medication Management, Nutrition Services, Behavioral Health Assessments, Crisis Services, and Care Coordination.
Desired Characteristics
Detail-oriented, self-motivated, organized, dependable, ethical, solution-focused, adaptable, collaborative, and committed to high-quality service delivery.
Physical Requirements
Ability to sit for extended periods, work at a computer for most of the day, occasionally lift up to 20 pounds, and communicate effectively.
Why Join Our Team?
Recovery Wellness Center of Eastern Washington is expanding behavioral health services to better serve our community. This role offers the opportunity to contribute to a mission-driven organization focused on improving access to quality mental health care while helping build efficient, scalable systems for the future.
Equal Opportunity Employer
Recovery Wellness Center of Eastern Washington is an Equal Opportunity Employer.
Pay: $23.00 - $30.00 per hour
Benefits:
- Flexible schedule
Experience:
- Medical billing: 2 years (Required)
Work Location: In person
Salary : $23 - $30