Behavioral Health Credentialing & RCM Specialist

Our client is a growing U.S.-based behavioral health practice specializing in medication management. The practice is expanding its direct insurance contracts and seeks a Credentialing & Revenue Cycle Specialist who can immediately take ownership of credentialing operations with minimal training. This role is ideal for someone with strong credentialing expertise, an understanding of revenue cycle management, and comfort navigating multi-state insurance paneling.

About the Role

Credentialing will be the primary focus during the initial months. Once the credentialing process is well established, the role will gradually expand into billing responsibilities, with the opportunity to transition into a full-time position as the practice grows.

Responsibilities

Primary Responsibilities (Credentialing - Immediate Focus)

• Manage the end-to-end credentialing process for behavioral health providers.
• Complete, maintain, and update CAQH profiles and supporting documentation.
• Submit and manage payer enrollment and insurance paneling applications.
• Coordinate credentialing across multiple insurance carriers and multiple states.
• Track application progress and proactively follow up with insurance carriers.
• Maintain accurate credentialing records and ensure provider compliance.
• Coordinate provider NPI information and insurance documentation.
• Manage credentialing timelines while identifying and resolving application delays.

Revenue Cycle Management (As Credentialing Stabilizes)

• Support revenue cycle operations, including insurance-related administrative workflows.
• Assist with billing processes after credentialing has been successfully established.
• Coordinate with insurance carriers regarding provider enrollment and reimbursement requirements.

Future Growth

As the practice expands, additional responsibilities may include:

• Medical billing
• Practice marketing support
• Additional healthcare administrative functions

Systems & Tools

• SimplePractice (Current EHR)
• Upheal (planned transition within the next 1–3 months)
• Spruce Health (Phone System)
• Availity
• CAQH
• Insurance Carrier Portals

Requirements

Must-Have Qualifications

• Hands-on credentialing experience in behavioral health or mental health (strongly preferred). Candidates with credentialing experience in other healthcare specialties will also be considered.
• Revenue Cycle Management (RCM) experience.
• Proficiency with Availity.
• Extensive experience with insurance paneling and payer enrollment.
• Experience managing credentialing across multiple insurance carriers and multiple states.
• Strong understanding of healthcare administrative workflows.
• Ability to work independently with minimal supervision.
• Excellent organizational skills with strong attention to detail.

Preferred Qualifications

• Familiarity with behavioral health insurance credentialing requirements.
• Experience working with CAQH and payer application workflows.
• Understanding of individual and group NPI structures.
• Experience communicating directly with insurance carriers.

Basic Requirements

• Must speak and write English clearly and professionally.
• Must have relevant work experience.
• Must be able to provide an NBI Clearance and/or Local Police Clearance before onboarding (mandatory).
• Must be available to attend video meetings with camera on when required.

Technical Requirements

• Reliable laptop or desktop computer.
• Stable high-speed internet connection (minimum 25 Mbps).
• Noise-canceling headset.
• Working webcam for virtual meetings.
• Quiet and professional work environment.

What We're Looking For

The ideal candidate can step into the role with minimal onboarding and confidently manage credentialing from day one. The client will not provide formal credentialing training, so candidates must already have practical experience navigating credentialing workflows independently. In addition to technical expertise, we're looking for someone who is:

• Highly proactive and communicative.
• A critical thinker who can troubleshoot issues independently.
• Resourceful and uses good judgment when managing complex processes.
• Organized and able to manage long credentialing timelines without constant supervision.

Benefits

• Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication.
• Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks.
• HIPAA & Cybersecurity Training + Certification (Provided): Access to internal HIPAA compliance training, cybersecurity modules, and certification.
• Top 1% VA Performance Training: Access to proprietary training on communication, client management, productivity systems, and best practices.
• Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule.
• Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client.
• Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support.
• Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on performance.

Any resources, training, or allowances listed are optional contractor perks and not employee benefits.