Billing and Credentialing Specialist

TIDES FAMILY SERVICES INC•West Warwick, RI

1d•$25 - $30

About The Position

Tides Family Services is a nonprofit organization that is committed to providing comprehensive support and resources to children, adolescents, and families facing various challenges. The overall mission of Tides is to provide services and supports that allow youth to live in a community-based setting. An "Agency Without Walls" our services are delivered in homes, communities, schools...wherever our youth are. Please note this is a part-time position. Position Overview: Tides Family Services is seeking a highly detail-oriented and proactive Billing & Credentialing Specialist to support the financial health and continued growth of our organization. This role is responsible for managing key components of the revenue cycle, including accurate claims submission, insurance follow-up, denial resolution, and provider credentialing. The Billing & Credentialing Specialist plays a critical role in ensuring timely reimbursement, maintaining payer compliance, and supporting sustainable operations. This position requires strong organizational skills, attention to detail, and the ability to work independently while managing multiple deadlines and payer requirements. The ideal candidate has experience in medical billing, insurance follow-up, and provider credentialing within a healthcare or behavioral health setting. They are solution-oriented, comfortable navigating payer systems, and committed to maintaining high standards of accuracy, accountability, and confidentiality. This is an opportunity to contribute meaningfully to a growing organization by strengthening revenue integrity and operational systems that directly support our clinical team and the families we serve.

Requirements

2+ years of medical billing experience required
Experience with provider credentialing and payer enrollment required
Knowledge of CPT, ICD-10, and HCPCS coding
Familiarity with commercial insurance and Medicaid processes
Strong organizational and time management skills with attention to detail.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and comfort with data entry systems.
Excellent written and verbal communication skills.
Ability to multitask and work both independently and as part of a team.

Nice To Haves

Experience with Echo Vantage preferred
CPC certification (or similar) a plus

Responsibilities

Submit accurate and timely insurance claims (electronic and paper)
Monitor claim status and resolve denials, rejections, and underpayments
Post payments and reconcile accounts
Conduct insurance follow-up and appeals as needed
Verify patient benefits and eligibility
Manage patient billing inquiries and payment plans
Ensure compliance with payer policies and regulations
Track and report key revenue cycle metrics
Complete initial and re-credentialing applications for commercial and government payers
Maintain CAQH profiles and ensure provider data is current
Track credentialing timelines and follow up with payers
Maintain accurate provider documentation and credentialing files
Assist with contracting and payer communications as needed