Medical Biller and Credentialing Specialist

Staffing For Doctors; United States; Remote; USD 34,000 - 55,000; Part time

Job summary

Staffing For Doctors is seeking an experienced Medical Biller and RCM Specialist to support a busy mental health clinic led by Dr. Mann. The role begins part-time (~20 hours/week) and will transition to full-time as in-house billing takes over.

You will audit and oversee an external billing agency through April 2027 and drive revenue recovery by resolving claims and backlog. The ideal candidate has 3+ years of U.S.

Qualifications

• 3+ years of U.S. medical billing and coding experience, with a mental health focus.
• In-depth knowledge of California payer landscapes, Medi-Cal, and state regulations.
• Experience auditing external billing vendors and managing revenue recovery.

Responsibilities

• Audit external billing agency submissions and cross-check OnlyMD encounters for unbilled items.
• Investigate 90 days of pending billing and 500+ unsubmitted encounters; liaise with payors.
• Maintain billing tracking logs in OnlyMD and resolve eligibility discrepancies.
• Identify denial root causes; perform corrective actions, appeals, and resubmissions.
• Document workflows to transition 100% of billing in-house after contract ends.

Skills

Medical Billing

RCM

Mental Health Billing

CPT/ICD-10 Coding

Attention to Detail

Tools

OnlyMD EMR

Practice VoIP System

Job description

Medical Biller And Rcm Specialist

We are seeking an experienced, detail-oriented, and highly analytical Medical Biller and RCM Specialist to support a busy mental health clinic led by Dr. Mann. In this critical revenue-recovery role, you will initially oversee and audit the output of an external, third-party medical billing company whose contract runs through April 2027. With approximately 90 days of pending billing and 500+ outstanding patient encounters, your mission is to identify claim bottlenecks, resolve billing errors, hold the external agency accountable, and directly recapture revenue for the practice.

The ideal candidate possesses 3+ years of U.S. medical billing and coding experience, specialized background in mental/behavioral health billing, and strong familiarity with California payer landscapes, Medi-Cal, and complex state compliance regulations. This position starts as a part-time role (~20 hours/week) for the first month with a direct path to full-time employment as you take over full in-house billing operations.

Role Title: Virtual Medical Billing Specialist & Revenue Oversight Lead

Specialty: Mental Health / Behavioral Health Clinic

Status: Part-Time (~20 Hours / Week for Month 1) transitioning to Full-Time based on revenue recovery and operational demand

Schedule: Flexible 4–5 hours per day within Monday – Friday, 10:00 AM – 7:00 PM PST (Pacific Standard Time)

Core Technology Stack: OnlyMD EMR & Billing System, Practice VoIP System, Dedicated Company Email Domain

Primary Objective: Revenue recovery, clearing a 500+ encounter backlog, external billing agency audit, and claim resolution

Top 3 Daily Tasks

1. External Billing Agency Audit & Monitoring: Review daily submissions from the current third-party billing company, cross-referencing OnlyMD EMR encounters against filed claims to uncover unbilled encounters, coding errors, and dropped tasks.
2. Backlog Clearance & Outstanding Claim Follow-Up: Investigate approximately 90 days of pending billing and 500+ unsubmitted encounters; communicate directly with payors and the billing agency to resolve rejections and denials.
3. Billing List & Patient Account Management: Maintain organized billing tracking logs in OnlyMD, resolve patient insurance eligibility discrepancies, and provide Dr. Mann with transparent weekly AR recovery reports.

Core Responsibilities

• Third-Party Agency Oversight: Serve as the practice's internal watchdog—auditing the external vendor's work, tracking claim transmission cadences, and flagging systematic errors or delays.
• Mental Health Billing & Coding Audit: Ensure accurate CPT/ICD-10 coding for behavioral health encounters, therapy sessions, and psychiatric evaluations within OnlyMD.
• Claims Tracking & Denial Management: Identify root causes for unpaid, rejected, or unsubmitted claims; execute corrective actions, appeals, and resubmissions.
• Payor & Regulatory Compliance: Navigate complex California state medical billing regulations, county/state-specific paperwork, and commercial/government payor guidelines to streamline credentialing and reimbursement.
• Full In-House Transition Preparation: Document billing workflows and prepare the practice to seamlessly bring 100% of billing operations in-house when the third-party contract concludes.