Medical Billing Associate, Credentialing
About The Position
The Medical Billing Associate – Credentialing Specialist supports The Warren Center’s mission by ensuring the agency and its therapists are properly enrolled and compliant with insurance payers. Reporting directly to the Chief Operating Officer, the role manages provider enrollment applications, credentials, licenses, renewals, re-attestations, and related documentation. The position also monitors payer applications through confirmation of in-network status and helps ensure regulatory compliance. The Warren Center advocates for, serves, and empowers children and families impacted by developmental delays and disabilities. Employees are expected to demonstrate the organization’s values: being family focused, respectful and collaborative, curious and committed to learning, and solution driven. The organization is an equal opportunity employer and provides reasonable accommodation to enable individuals with disabilities to perform essential job functions.
Requirements
- High school diploma or GED.
- At least 3 years of experience in medical billing, with a focus on credentialing and recredentialing requirements.
- High energy and passion for The Warren Center’s mission.
- Ability to maintain a high level of confidentiality with personnel information.
- Flexible and adaptable style.
- Clear and concise communication skills.
- Professional, dependable, and proactive approach.
- Ability to work independently without close oversight and collaboratively with people at varying levels of seniority inside and outside the organization.
- Strong organizational and time-management skills, with exceptional attention to detail.
- Advanced knowledge of Microsoft Office Suite, including Word, Excel, Outlook, SharePoint/OneDrive, and Teams.
- Good finger dexterity and vision.
Responsibilities
- Compile and maintain records of licenses, credentials, and insurance contracts.
- Advise staff on renewal procedures.
- Complete and submit provider enrollment applications required by Medicaid and commercial payers.
- Conduct primary source verification of licenses, education, and certifications.
- Manage re-credentialing and license or certification renewal deadlines.
- Ensure compliance with regulatory standards.
- Prepare reports required by regulatory and accrediting agencies.
- Communicate with providers, their liaisons, and representatives.
- Capture primary source documentation in computer databases.
- Liaise with providers, payers, and internal departments.
- Treat internal and external customers with respect and provide knowledgeable answers and a welcoming attitude.
- Enter data and maintain provider information in online credentialing databases and systems, including NPPES, CAQH, and TMHP.
- Audit applications for accuracy and completeness.
- Manage revalidation requests issued by payers.
- Monitor application progress and follow up with payers until confirmation of in-network status is received.
- Track required documentation, expiration dates, and insurance re-attestation dates, and ensure information is current and submitted on time.
- Research and gather pertinent information regarding providers.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
