Remote Part-time Payer Contracting & Credentialing Specialist

This is a remote position.

• Payer Contracting: Prepare and submit commercial and Medicaid organizational applications, coordinate managed care organization (MCO) enrollment and revalidation, and track contracting milestones, renewals, and outstanding requirements.
  
  
• Reimbursement Analysis: Review payer contracts and fee schedules, identify reimbursement variances, and flag provisions that may create operational or financial risk.
  
  
• Credentialing and Enrollment: Manage organizational Type 2 NPI enrollments and service location additions, verify taxonomy alignment with licensed levels of care, and coordinate applicable CAQH profile updates.
  
  
• Revenue Integrity: Conduct focused reviews of behavioral health CPT and HCPCS billing practices against payer policies, covered services, and fee schedule requirements.
  
  
• Risk Identification: Evaluate authorization and documentation requirements, analyze denial patterns, and recommend corrective actions to leadership.
  
  
• Medicaid Research: Research state Medicaid fee schedules, managed care reimbursement structures, and provider manuals, preparing written findings to support expansion into new states.
  
  
• Reporting and Tracking: Summarize reimbursement findings and potential financial impacts for executive review, and maintain accurate contracting and enrollment records.
  

Requirements

• Experience: At least three years of behavioral health payer contracting experience, including Medicaid MCO enrollment and commercial payer contracting.
  
  
• Technical Knowledge: Working knowledge of behavioral health CPT and HCPCS codes, level-of-care billing requirements, and ASAM levels of care.
  
  
• Analytical Skills: Demonstrated ability to interpret Medicaid fee schedules, payer policies, and contract provisions to identify reimbursement discrepancies and operational risks.
  
  
• Communication: Strong written communication skills, with the ability to deliver clear findings and actionable recommendations within established timelines.
  
  
• Independent Work: Ability to prioritize assignments, manage deadlines, and exercise sound judgment within a defined scope focused on contracting, credentialing, and analysis.  Claims submission and day-to-day revenue cycle management are outside this role’s scope.
  
  
• Preferred Background: Multi-state Medicaid experience and experience supporting a consulting organization, management services organization (MSO), or multiple facilities.
  

Benefits

• Meaningful Work: Support an organization committed to ethical, high-quality behavioral health and substance use disorder treatment.
  
  
• Flexible Schedule: Work remotely approximately 10 hours per week, with primarily asynchronous responsibilities and occasional scheduled meetings.
  
  
• Professional Impact: Apply your expertise to strengthen payer relationships, support reimbursement accuracy, and improve financial and operational performance.
  
  
• Compensation: $50 per hour as a part-time W-2 employee.