Certified Medical Biller and Credentialing Specialist

Job Description Job Description Position Overview Collaborative Psychology Group, APC is a growing multidisciplinary behavioral health practice comprised of psychologists, therapists, psychiatric nurse practitioners, and allied mental health professionals. We are seeking an experienced and detail-oriented Mental Health Medical Biller who understands the complexities of behavioral health reimbursement, payer requirements, payer contracts, and psychiatric/psychological coding. The ideal candidate is highly knowledgeable in behavioral health billing workflows, insurance follow-up, denial management, credentialing, and revenue cycle optimization. This individual must be proficient in the Tebra EHR/practice management system and stay informed regarding evolving CPT coding standards, payer trends, telehealth regulations, Inland Regional Center billing requirements, and reimbursement opportunities within mental health and integrated care. This role is critical to maintaining the financial health of the organization while supporting ethical, compliant, and timely billing practices. Key Responsibilities Revenue Cycle Management Submit accurate and timely electronic claims for: Psychologists Licensed therapists/associates Psychiatric nurse practitioners Group therapy and specialty behavioral health services Manage the full lifecycle of claims from charge entry through payment posting and collections. Monitor aging reports and aggressively follow up on unpaid, delayed, or denied claims. Identify trends contributing to revenue leakage and recommend corrective actions. Ensure clean claims submission and reduce denials through proactive auditing. Behavioral Health Billing Expertise Maintain advanced knowledge of mental health CPT coding including but not limited to: 90791, 90792 90832, 90834, 90837 90846, 90847, 90853 96127 and psychological testing codes Medication management and E/M codes Prolonged services Telehealth modifiers and POS coding Crisis billing codes Stay informed on higher reimbursement CPT opportunities that are clinically and ethically appropriate. Understand payer-specific documentation requirements tied to behavioral health reimbursement. Maintain awareness of Medicare, Medi-Cal/Medicaid, commercial insurance, and managed care updates affecting behavioral health. Possess familiarity with Inland Regional Center authorization, invoicing, and billing processes. Understand contract-based reimbursement structures and fee schedules for behavioral health services. Contracting & Credentialing Assist with provider credentialing and recredentialing processes for: Commercial insurance panels Medi-Cal/Medicaid plans Medicare enrollment Behavioral health managed care organizations Track provider enrollment timelines, CAQH updates, and payer application requirements. Maintain organized credentialing records and ensure timely renewals. Review and monitor payer contracts, reimbursement schedules, and contract compliance. Identify reimbursement discrepancies and escalate payer underpayments when appropriate. Assist leadership with gathering data related to contract negotiations and reimbursement analysis. Maintain familiarity with Inland Regional Center vendorization and billing compliance standards. Tebra EHR & Practice Management Utilize Tebra EHR/PM system efficiently for: Insurance verification Claims management ERA/EFT reconciliation Reporting Patient statements Eligibility checks Workflow optimization Assist in identifying system inefficiencies and improving billing workflows within Tebra. Collaborate with clinical and administrative teams to ensure accurate charting and claim readiness. Compliance & Quality Assurance Ensure billing practices remain compliant with: HIPAA CMS regulations Commercial payer guidelines California behavioral health billing standards Inland Regional Center billing requirements Conduct routine internal audits to ensure coding accuracy and reduce compliance risk. Maintain confidentiality and security of protected health information. Collaboration & Communication Work closely with clinicians and leadership regarding documentation corrections, authorization issues, payer concerns, and credentialing matters. Educate providers on billing trends, coding updates, and documentation requirements when needed. Communicate professionally with patients regarding balances, benefits, and billing inquiries. Qualifications Required Minimum 2–3 years of behavioral health or psychiatric billing experience. Direct experience billing for multidisciplinary mental health providers. Proficiency with Tebra/Kareo EHR and practice management systems. Strong understanding of behavioral health CPT, ICD-10, and HCPCS coding. Experience with commercial insurance, Medicare, Medi-Cal/Medicaid, managed care plans, and regional center billing. Knowledge of telehealth billing regulations and modifier usage. Experience with denial resolution and appeals. Familiarity with provider credentialing processes and payer enrollment. Strong organizational skills and attention to detail. Ability to work independently while managing multiple priorities. Preferred Certified Professional Biller (CPB), CPC, or related certification. Experience with Inland Regional Center billing and vendorization processes. Familiarity with payer contracting and reimbursement analysis. Experience with psychological testing billing. Experience in integrated care or multidisciplinary group practice environments. Knowledge of California behavioral health regulations and payer trends. Ideal Candidate Traits Analytical and proactive problem solver Ethical and compliance-minded Revenue-focused while maintaining patient-centered values Highly organized and deadline-oriented Comfortable in a fast-paced, growing healthcare environment Strong communicator with clinicians, administrative teams, and insurance representatives