Medical Billing, Credentialing & Coding Specialist

Job Description

Job Description

Join Our Team

We are a mission-driven behavioral health organization committed to empowering individuals on their recovery journey. We are seeking an experienced Medical Billing, Credentialing & Coding Specialist responsible for managing the full revenue cycle, including insurance billing, provider credentialing, and accurate medical coding for a behavioral health organization. This role ensures compliance with payer requirements, supports timely reimbursement, and maintains provider enrollment through CAQH and other credentialing platforms

Summary of Responsibilities:

Medical Billing & Revenue Cycle

·         Submit accurate and timely claims for mental health and substance use disorder services

·         Monitor claim status, resolve denials, and follow up on unpaid claims

·         Post payments and reconcile accounts receivable

·         Verify patient insurance eligibility and benefits

·         Ensure compliance with payer guidelines, including Medicaid, Medicare, and commercial plans

Credentialing & Provider Enrollment

·         Manage provider credentialing and recredentialing processes

·         Maintain and update CAQH profiles for all clinicians

·         Submit and track applications with insurance panels (Medicaid, Medicare, commercial payers)

·         Ensure licenses, certifications, malpractice insurance, and other required documents are current

·         Maintain credentialing database and audit readiness

Medical Coding

·         Assign accurate CPT , ICD-10-CM , and HCPCS codes for behavioral health services

·         Ensure documentation supports coding and billing compliance

·         Stay current with coding updates specific to mental health and substance abuse services

·         Conduct periodic chart audits to ensure coding accuracy

Compliance & Reporting

·         Ensure adherence to HIPAA and regulatory requirements

·         Support internal and external audits

·         Generate billing and credentialing reports for leadership

·         Identify trends in denials and recommend process improvements

Education & Experience:

·         High school diploma or GED equivalent

·         3+ years of experience in medical billing, coding, and credentialing

Preferred Qualifications

·         Associate’s or Bachelor’s degree

·         Experience in behavioral health, mental health, or substance abuse setting

·         CPC (Certified Professional Coder), CCS, or equivalent

EnoughCS is dedicated to elevating the quality of life for the individuals it serves, by utilizing its innovative strategic collaborative approach creating a clear achievable path to success through connecting individuals dealing with substance abuse, poor mental health, or re-entry that focuses on the barriers that have impeded long term recovery. We understand addressing a person's wellness with respect, dignity and compassion will create a better individual family and community. EnoughCS believes that what we can't do can still be addressed with the help of other community partners.
Our services provided are behavioral health, mental health and substance abuse treatment through IOP and PHP programs.

Company Description

EnoughCS is dedicated to elevating the quality of life for the individuals it serves, by utilizing its innovative strategic collaborative approach creating a clear achievable path to success through connecting individuals dealing with substance abuse, poor mental health, or re-entry that focuses on the barriers that have impeded long term recovery. We understand addressing a person's wellness with respect, dignity and compassion will create a better individual family and community. EnoughCS believes that what we can't do can still be addressed with the help of other community partners.\r\nOur services provided are behavioral health, mental health and substance abuse treatment through IOP and PHP programs.