Credentialing & Billing Specialist—Medicare Enrollment

RiseMe; Birmingham (AL); On-site; USD 45,000 - 62,000; Full time

Job summary

RiseMe is seeking a Credentialing/Billing Specialist to handle insurance credentialing, recredentialing, and claims processing for outpatient mental health services in Birmingham, AL. The role supports Medicare, Medicaid, and commercial payers and ensures compliance with federal/state rules.

The ideal candidate has 2–3 years of medical billing experience in mental health, 1 year in credentialing, and relevant certifications are a plus.

Qualifications

• High School Diploma or GED required.
• Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred.
• 2–3 years in medical billing, with a focus on mental health services.
• 1 year experience in insurance credentialing, provider enrollment, and payer requirements.
• Certifications (Desired): CPCS, CPC, CPB, or similar.

Responsibilities

• Lead Medicare and commercial payer enrollment and credentialing processes.
• Manage provider credentialing and recredentialing with Medicaid, Medicare, and commercial payers.
• Ensure all credentials are up to date and compliant with payer requirements.
• Maintain HIPAA compliance across credentialing activities.
• Perform electronic billing and claims processing for non-Medicaid clients on a routine basis.
• Process and post incoming payments for non-Medicaid claims.
• Review, analyze, and resolve denied or underpaid non-Medicaid claims.
• Coordinate provider enrollment and revalidation with Medicare, Medicaid, and commercial carriers.

Skills

Credentialing knowledge

Payer enrollment

CPT/ICD-10 coding

HIPAA compliance

Attention to detail

Communication skills

Education

High School Diploma or GED

Associate or Bachelor’s in Healthcare Admin/Business Admin

Job description

RiseMe is seeking a Credentialing/Billing Specialist to handle insurance credentialing, recredentialing, and claims processing for outpatient mental health services in Birmingham, AL. The role supports Medicare, Medicaid, and commercial payers and ensures compliance with federal/state rules.

The ideal candidate has 2–3 years of medical billing experience in mental health, 1 year in credentialing, and relevant certifications are a plus.