Billing and Credentialing Specialist

Behavioral Framework - the leading provider of ABA therapy to children diagnosed with autism in the DMV area - is looking for a Billing and Credentialing Specialist.The Billing and Credentialing Specialist is responsible for insurance billing and credentialing including tracking claim status, resolving claim denials, billing errors and issues with various insurance companies as well as maintaining active status for all providers by successfully completing initial and subsequent credentialing applications as required by various government and commercial payers. This position reports to the Client Services Manager.Behavioral Framework Highlights:Behavioral Framework is devoted to the pursuit of providing excellent, honest, and compassionate care within the autism community.We believe in the dedication and passion of our professional team and the science behind ABA to make a difference in the families and children we serve.Ranked on the Inc. 5000 list for 3 consecutive years.1 of 4 Autism providers in the country to earn 3-year accreditation + telehealth from the Behavioral Health Center of ExcellenceBeautiful new office 2 minutes from I-270Essential FunctionsInsurance Billing Learn existing billing processes in Rethink Behavioral Health and Kareo. Track status of payments, reconcile payments, and follow up on billing errors and issues. Research and resolve denied claims. Assist with patient collection, send patient statements, and follow up. Assist in preparing weekly reports to management summarizing billing activity (claims submitted, claims denied, remittance received, etc.). Perform administrative and other tasks as needed.Insurance Credentialing Submit and track credentialing requests to various commercial and government payers. Manage re-credentialing for all providers. Assist providers with setting up and maintaining CAQH profiles Performs other duties as assigned.Knowledge, Skills, Experience Maintain confidentiality; adhere to all HIPAA guidelines/regulations. Knowledge of the behavioral health industry and terms. Experience in managing recordkeeping and tracking systems. Experience with medical billing and claims processing. Experience with medical credentialing Experience working with insurance companies. Knowledge of regulations related to Medicaid and commercial insurance. Knowledge of industry regulations. Excellent attention to detail and accuracy in entering financial data. Excellent organizational skills, deadline-driven with excellent time management ability. Outstanding math and research skills. Proficiency in Microsoft Office Suite. Working knowledge of Kareo and Rethink Behavioral Health systems. Min High School diploma, college degree preferredWork Environment, Physical Conditions Ability to work in a fast-paced environment. Ability to work 40 hours per week. Ability to work cooperatively with others. Must comply with practice policies and procedures. Requires daily in-office work. Does not meet the requirements of regular telecommuting. Physical activities include sitting for long periods of time, walking, bending, kneeling. Must be able to reach, pull, and push. Requires manual dexterity, auditory and visual skills. Ability to lift up to 15 lbs.Salary: $50,000-55,000kEOEBehavioral Framework is committed to equitable treatment for all employees, clients, and their families. We welcome and respect the diversity of the families we serve, and we focus our organizational efforts to build a culture of respect, dignity, fairness, caring, equality, and self-esteem.We believe our strength comes from the shared experiences of our employees, clients, and community. We pride ourselves on serving a diverse population and always seeking to hire, retain, and promote from a wide variety of backgrounds.#BFADMIN

Created: 2025-02-18