Billing and Credentialing Specialist

1 day ago Be among the first 25 applicants

This range is provided by McHur Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$16.00/hr - $24.00/hr

Position Summary:

The Billing & Credentialing Representative supports billing, authorizations, claims follow-up, and provider credentialing/enrollment activities. This role helps ensure services are properly authorized, claims are accurately submitted and resolved, and provider credentials remain current with Texas Medicaid, managed care organizations (MCOs), and related partner requirements.

• Billing & Revenue Cycle Support
• Obtain and track initial and continued authorizations for services
• Prepare, review, and submit claims through payor portals and/or clearinghouses
• Post payments and adjustments based on ERAs/EOBs
• Research and resolve denials/underpayments; resubmit corrected claims as needed
• Monitor aging accounts receivable and work balances to reduce outstanding AR
• Communicate with payors regarding coverage, benefits, and claim status
• Coordinate with internal teams to resolve billing discrepancies (demographics, insurance, documentation, etc.)
• Credentialing & Provider Enrollment – coordinate credentialing and re-credentialing for providers with corporate partners and payors
• Prepare and submit enrollment applications for Texas Medicaid and Medicaid MCOs (and other payors as needed)
• Maintain provider profiles (e.g., CAQH, NPPES, TMHP, MCO portals)
• Track deadlines/expirations and follow up proactively to prevent lapses
• Support providers in gathering, completing, and submitting required documentation
• Maintain organized digital credentialing and enrollment records
• Compliance, Quality & Reporting – follow all applicable federal/state requirements, Texas Medicaid guidance, and Internal policies
• Protect PHI and maintain strict confidentiality in accordance with HIPAA
• Support audits and provide basic reporting (authorizations, denials, credentialing status, expirations, etc.)
• Collaboration & Communication – serve as a point of contact for billing and credentialing questions
• Coordinate with payors and external stakeholders as needed
• Communicate clearly and professionally with internal teams and providers

Required

• High school diploma or equivalent
• 1–3 years of experience in medical or behavioral health billing, revenue cycle, and/or credentialing
• Experience with Medicaid, MCOs, and insurance verification/authorization processes
• Strong organization, attention to detail, and written/verbal communication skills

Preferred

• Associate’s degree or higher in healthcare administration, business, or a related field
• Behavioral health and/or Texas Medicaid experience
• Credentialing/provider enrollment experience (e.g., CAQH, TMHP, MCO portals)

• Working knowledge of billing concepts (CPT/HCPCS, modifiers, EOB/ERA, denials, adjustments)
• Proficiency with Microsoft Office and practice management/EHR systems
• Ability to manage multiple priorities, meet deadlines, and work with minimal oversight
• Strong customer service mindset and professional communication
• High integrity and consistent handling of sensitive/confidential information

Entry level

Full-time

Accounting/Auditing and Finance

Mental Health Care

Referrals increase your chances of interviewing at McHur Care by 2x