Part-time Payer Contracting & Credentialing Specialist

Florida City, FL - USA

Hourly Salary: $ 50 - 50

Experience Required: 1-3years

Posted on: Yesterday

Vacancies: 1 Vacancy

Job Summary

This is a remote position.

Atlantic Health Strategies is seeking a Part-time Payer Contracting & Credentialing this part-time remote role the Payer Contracting & Credentialing Specialist serves as a specialized operational partner to the leadership team. This position supports commercial and Medicaid contracting credentialing reimbursement analysis and billing compliance reviews. The Specialist plays a critical role in ensuring revenue integrity maintaining accurate payer enrollments and identifying financial risks before they impact the organization. This is a highly analytical role requiring independent judgment. Work is primarily asynchronous and email-based with occasional client-facing Teams meetings.

What You Will Do at Atlantic Health Strategies

Payer Contracting: Prepare and submit commercial and Medicaid organizational applications manage MCO enrollment and revalidation processes and maintain contracting trackers and renewal timelines.
Reimbursement Analysis: Review reimbursement schedules identify rate variances and flag contract language that presents operational or financial risk.
Credentialing Management: Manage Type 2 NPI enrollments and service location additions ensuring taxonomy alignment with licensed levels of care and coordinate CAQH updates.
Revenue Integrity: Conduct focused billing compliance reviews of behavioral health CPT/HCPCS codes and compare billed services against payer policy and fee schedule guidance.
Risk Mitigation: Identify authorization and documentation risk areas analyze denial patterns and recommend corrective actions to leadership.
Medicaid Research: Research state Medicaid fee schedules and managed care reimbursement structures interpret provider manuals and provide written analysis to support expansion into new states.
Performance Reporting: Summarize reimbursement impact for executive review and maintain accurate current contracting logs.

What You Bring to Atlantic Health Strategies

Experience: Minimum 3 years of behavioral health payer contracting experience specifically with Medicaid MCO enrollment and commercial payer contracting.
Technical Knowledge: Working knowledge of behavioral health CPT/HCPCS codes level-of-care billing and ASAM levels of care.
Analytical Skills: Experience analyzing Medicaid fee schedules and payer policy documents to identify variances and risks.
Communication: Strong written communication skills and the ability to provide clear written reimbursement analysis within defined timelines.
Independence: Ability to operate within a defined scope without drifting into claims submission or RCM execution.
Preferred Background: Multi-state Medicaid experience and experience in a consulting MSO or multi-facility environment is highly preferred.

Why Join Atlantic Health Strategies

Mission-Driven: Be part of an organization committed to ethical high-quality addiction treatment.
Flexibility: This role is primarily asynchronous and email-based allowing for a flexible schedule (approx. 10 hours per week).
Professional Impact: A meaningful role where your operational expertise directly supports the financial health and compliance of the organization.
Compensation: Competitive hourly rate of $50/hour (W2).

Requirements

Ability to work remote approximately 10 hours per week.
Minimum 3 years of behavioral health payer contracting experience.
Direct experience with Medicaid MCO enrollment and commercial payer contracting.
Working knowledge of behavioral health CPT/HCPCS codes and level-of-care billing
Strong organizational documentation and interpersonal skills.
Ability to work independently and collaborate effectively via email and occasional Teams meetings.
Ability to maintain compliance with HIPAA and relevant behavioral health regulations.

Benefits

Competitive Pay ($50/hour)
Remote / Work-from-home

Required Skills:

Ability to work remote approximately 10 hours per week. Minimum 3 years of behavioral health payer contracting experience. Direct experience with Medicaid MCO enrollment and commercial payer contracting. Working knowledge of behavioral health CPT/HCPCS codes and level-of-care billing Strong organizational documentation and interpersonal skills. Ability to work independently and collaborate effectively via email and occasional Teams meetings. Ability to maintain compliance with HIPAA and relevant behavioral health regulations.

This is a remote position. Atlantic Health Strategies is seeking a Part-time Payer Contracting & Credentialing this part-time remote role the Payer Contracting & Credentialing Specialist serves as a specialized operational partner to the leadership team. This position supports commercial and Me...

This is a remote position.

What You Will Do at Atlantic Health Strategies

Payer Contracting: Prepare and submit commercial and Medicaid organizational applications manage MCO enrollment and revalidation processes and maintain contracting trackers and renewal timelines.
Reimbursement Analysis: Review reimbursement schedules identify rate variances and flag contract language that presents operational or financial risk.
Credentialing Management: Manage Type 2 NPI enrollments and service location additions ensuring taxonomy alignment with licensed levels of care and coordinate CAQH updates.
Revenue Integrity: Conduct focused billing compliance reviews of behavioral health CPT/HCPCS codes and compare billed services against payer policy and fee schedule guidance.
Risk Mitigation: Identify authorization and documentation risk areas analyze denial patterns and recommend corrective actions to leadership.
Medicaid Research: Research state Medicaid fee schedules and managed care reimbursement structures interpret provider manuals and provide written analysis to support expansion into new states.
Performance Reporting: Summarize reimbursement impact for executive review and maintain accurate current contracting logs.

What You Bring to Atlantic Health Strategies

Experience: Minimum 3 years of behavioral health payer contracting experience specifically with Medicaid MCO enrollment and commercial payer contracting.
Technical Knowledge: Working knowledge of behavioral health CPT/HCPCS codes level-of-care billing and ASAM levels of care.
Analytical Skills: Experience analyzing Medicaid fee schedules and payer policy documents to identify variances and risks.
Communication: Strong written communication skills and the ability to provide clear written reimbursement analysis within defined timelines.
Independence: Ability to operate within a defined scope without drifting into claims submission or RCM execution.
Preferred Background: Multi-state Medicaid experience and experience in a consulting MSO or multi-facility environment is highly preferred.

Why Join Atlantic Health Strategies

Mission-Driven: Be part of an organization committed to ethical high-quality addiction treatment.
Flexibility: This role is primarily asynchronous and email-based allowing for a flexible schedule (approx. 10 hours per week).
Professional Impact: A meaningful role where your operational expertise directly supports the financial health and compliance of the organization.
Compensation: Competitive hourly rate of $50/hour (W2).

Requirements

Ability to work remote approximately 10 hours per week.
Minimum 3 years of behavioral health payer contracting experience.
Direct experience with Medicaid MCO enrollment and commercial payer contracting.
Working knowledge of behavioral health CPT/HCPCS codes and level-of-care billing
Strong organizational documentation and interpersonal skills.
Ability to work independently and collaborate effectively via email and occasional Teams meetings.
Ability to maintain compliance with HIPAA and relevant behavioral health regulations.