Behavioral Health Credentialing, RCM Specialist

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Oversee the complete credentialing process for behavioral health providers.

• Create, maintain, and update CAQH profiles along with necessary documentation.

• Submit and handle applications for payer enrollment and insurance paneling.

• Manage credentialing activities across various insurance carriers and states.

• Monitor the progress of applications and proactively engage with insurance carriers.

• Keep precise credentialing records and ensure provider adherence to compliance standards.

• Coordinate provider NPI details and insurance paperwork.

• Oversee credentialing timelines while identifying and addressing application delays.

• Assist with revenue cycle operations, including administrative workflows related to insurance.

• Support billing processes once credentialing has been successfully established.

• Liaise with insurance carriers concerning provider enrollment and reimbursement prerequisites.

• As the practice grows, additional tasks may encompass medical billing, practice marketing support, and other healthcare administrative duties.

⛳️ Requirements

• Medical degree required: No

• Previous Virtual Assistant experience: Preferred

• Medical license required: No

• Practical credentialing experience in behavioral health or mental health (strongly preferred).

• Candidates with credentialing experience in other healthcare fields will also be taken into account.

• Experience in Revenue Cycle Management (RCM).

• Proficiency in Availity.

• Extensive experience with insurance paneling and payer enrollment processes.

• Experience managing credentialing across multiple insurance carriers and states.

• Strong knowledge of healthcare administrative workflows.

• Ability to work autonomously with minimal supervision.

• Exceptional organizational abilities and keen attention to detail.

• Familiarity with behavioral health insurance credentialing standards.

• Experience with CAQH and payer application processes.

• Understanding of individual and group NPI frameworks.

• Experience communicating directly with insurance providers.

• Must have clear and professional spoken and written English skills.

• Must possess relevant work experience.

• Must be able to provide an NBI Clearance and/or Local Police Clearance prior to onboarding (mandatory).

• Must be available for video meetings with the camera on when necessary.

🏝️ Benefits

• Dedicated HR & Contractor Support Team: Access to exceptional support for inquiries, guidance, contract issues, and client communications.

• Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance confidentiality and security for client-related tasks.

• HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to empower you to manage PHI confidently for U.S. healthcare clients.

• Top 1% VA Performance Training: Gain access to our proprietary training on communication, client management, productivity systems, and best practices to help you excel as a top-performing VA and improve long-term client retention.

• Client-Approved U.S. Holidays: Contractors may take U.S. holidays off in alignment with the client’s needs and schedule.

• Client-Approved Paid or Unpaid Time Off: Time off may be authorized by your client. Paid time off is optional and only if provided by the client.

• Access to Tools & Resources: Utilize templates, workflow guides, productivity tools, and client-specific SOP support to help you excel in your role.

• Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.