Billing & Credentialing Specialist (Behavioral Health – Remote)

Full Job Description

Canopy Mental Health & Consulting is seeking an experienced Billing & Credentialing Specialist to manage end-to-end billing operations and provider credentialing for behavioral health services.

This role is critical to maintaining a healthy revenue cycle, ensuring compliance with Medicaid (MHCP), Medicare, and commercial payer requirements, and supporting both internal teams and clients with clarity and accuracy.

You will work cross-functionally with finance, clinical, and operations teams to manage claims, reduce denials, maintain payer relationships, and ensure credentialing compliance.

This is a full-time remote role working U.S. Central hours.

Job Responsibilities

Manage full-cycle behavioral health billing, including claim submission, posting, and reconciliation

Verify insurance eligibility, obtain prior authorizations, and ensure clean claims submission

Handle denial management, appeals, and corrected claims

Monitor accounts receivable and follow up on outstanding balances

Maintain compliance with Medicaid (MHCP), Medicare, and commercial payer rules

Manage provider credentialing and recredentialing across payers

Maintain CAQH profiles and payer portal data

Track credentialing timelines, expirations, and enrollments

Support audit readiness and ensure HIPAA compliance

Collaborate with finance and clinical teams to resolve billing issues

Communicate with clients regarding billing questions and payment options

Generate reports and track KPIs such as AR aging and denial rates

Job Requirements

5+ years of experience in behavioral health billing

2+ years of credentialing experience

Strong knowledge of Medicaid (MHCP), Medicare, and commercial payer processes

Proficiency in CPT and ICD-10 coding (behavioral health)

Experience with claims lifecycle, denials, and appeals

Experience using CAQH and payer portals

Familiarity with EHR billing systems (Procentive preferred)

Strong attention to detail and organizational skills

Ability to manage multiple priorities independently

Excellent written and verbal English communication skills

Skills Required

• Finance - Expert

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