Especialista en facturación médica y acreditación de seguros Job Saint Paul Minnesota USA,Healthcare

Benefits:

401(k)
Employee discounts
Health insurance
Paid time off

Company:

Nutritional Weight & Wellness

Job Type:

Full-Time

Location:

St. Paul, MN (Hybrid)

First, a little about us.

We help people build healthier lives - and we think that starts with our own team. Weight & Wellness is a small, people-first nutrition practice where work/life balance is real, every team member matters, and no one is just a job title. If you've worked at a place where your effort went unnoticed, this will feel different.

Now, the role.

We're bringing insurance billing in-house and need a skilled billing and credentialing specialist to own it. You'll work inside Healthie (EHR) and ClaimMD (EDI) - modern tools that handle a lot of the heavy lifting - but this role still requires a sharp, experienced person who knows how to read a denial, fix a claim, credential a provider, and talk to a client about their benefits without making their eyes glaze over.

What

You'll Own:

Submitting claims from Healthie to ClaimMD and staying on top of what comes back
Resolving denied or rejected claims
- ClaimMD surfaces the reason codes, you take it from there (corrections, resubmissions, or formal appeals)
Eligibility verification before appointments
- ClaimMD covers most payers; you'll handle the rest through payer portals
Invoicing clients for copays and coinsurance once the insurance payment is received
Managing accounts receivable and following up on aging balances
Tracking referral requirements and coordinating with clients and referring providers when needed
Handling prior authorizations for the occasional plan that requires it (not common for MNT, but it does come up with some Medicaid and HMO plans)
Credentialing new providers and keeping everything current - CAQH profiles, revalidations, payer enrollments, expiring documents
Being the person the front desk staff, clients and providers turn to when they have an insurance question - and actually helping them understand the answer

What We're Looking For:

4+ years of medical billing experience (nutrition or wellness setting is a bonus)
ClaimMD or equivalent clearinghouse experience
Solid CPT/ICD-10 coding knowledge, especially MNT codes (97802, 97803, 97804)
Credentialing experience - CAQH, payer enrollment, the whole process
Comfortable with payer portals (Availity, Navi Net, etc.)
A communicator who can explain insurance in plain English
Someone who runs their own work, hits their own deadlines, and doesn't need to be managed

What You'll Get:

A team that actually respects your personal time
Recognition for the work you do - in a small practice, good work doesn't go unnoticed
Room to make this role your own and improve how things run
Competitive pay based on your experience
Health Insurance, Paid Time Off, 401K, Life Insurance, Employee Discount

Flexible work from home options available.