Remote Part-time Payer Contracting & Credentialing Specialist

Atlantic Health Strategies; United States; Remote; USD 57,000 - 81,000; Part time

Job summary

Atlantic Health Strategies is seeking a Remote Part-Time Payer Contracting & Credentialing Specialist to support commercial and Medicaid payer contracting, credentialing, and reimbursement analysis for a behavioral health-focused client. The role is largely asynchronous with occasional Microsoft Teams meetings and requires about 10 hours per week.

The Specialist will maintain payer enrollments, evaluate reimbursement requirements, and ensure integrity of enrollment records, contributing to

Qualifications

• Three years of behavioral health payer contracting experience, including Medicaid MCO enrollment.
• Working knowledge of behavioral health CPT/HCPCS codes and level-of-care billing requirements.
• Ability to interpret Medicaid fee schedules, payer policies, and contract provisions to identify reimbursement discrepancies and operational risks.
• Strong written communication skills with the ability to deliver clear findings within timelines.
• Independent worker able to manage deadlines within a defined scope.

Responsibilities

• Payer Contracting: Prepare and submit commercial and Medicaid enrollments, track milestones, renewals and outstanding requirements.
• Reimbursement Analysis: Review payer contracts and fee schedules, identify variances and risk.
• Credentialing and Enrollment: Manage Type 2 NPI enrollments, verify taxonomy alignment, CAQH updates.
• Revenue Integrity: Conduct focused reviews of CPT/HCPCS billing against payer policies and fee schedules.
• Risk Identification: Evaluate authorization/documentation requirements and denial patterns to guide actions.
• Medicaid Research: Research state Medicaid fee schedules and payer manuals for expansion.
• Reporting and Tracking: Summarize findings for executive review and maintain enrollment/contracting records.

Skills

Analytical skills

Written communication

Independent work

Prioritization

Attention to detail

Job description

Remote Part-time Payer Contracting & Credentialing Specialist

Remote | Approximately 10 hours per week | $50 per hour | W-2 employment

About the Organization

Our client is a behavioral health treatment organization serving individuals navigating substance use disorders, mental health conditions, and related behavioral health needs.

The organization believes strong treatment programs depend on engaged operational leadership, responsive teams, accountability, and an environment where patients and employees feel supported.

The Opportunity

Our client is seeking a Part-Time Payer Contracting & Credentialing Specialist. This position partners with the client’s leadership team to support commercial and Medicaid payer contracting, credentialing, reimbursement analysis, and focused billing compliance reviews.

The Specialist helps protect revenue integrity by maintaining accurate payer enrollments, evaluating reimbursement requirements, and identifying operational and financial risks before they affect the organization. This highly analytical position requires independent judgment, attention to detail, and clear written communication. Work is primarily asynchronous and email-based, with occasional Microsoft Teams meetings.

Key Responsibilities

• Payer Contracting: Prepare and submit commercial and Medicaid organizational applications, coordinate managed care organization (MCO) enrollment and revalidation, and track contracting milestones, renewals, and outstanding requirements.
• Reimbursement Analysis: Review payer contracts and fee schedules, identify reimbursement variances, and flag provisions that may create operational or financial risk.
• Credentialing and Enrollment: Manage organizational Type 2 NPI enrollments and service location additions, verify taxonomy alignment with licensed levels of care, and coordinate applicable CAQH profile updates.
• Revenue Integrity: Conduct focused reviews of behavioral health CPT and HCPCS billing practices against payer policies, covered services, and fee schedule requirements.
• Risk Identification: Evaluate authorization and documentation requirements, analyze denial patterns, and recommend corrective actions to leadership.
• Medicaid Research: Research state Medicaid fee schedules, managed care reimbursement structures, and provider manuals, preparing written findings to support expansion into new states.
• Reporting and Tracking: Summarize reimbursement findings and potential financial impacts for executive review, and maintain accurate contracting and enrollment records.

Requirements

• Experience: At least three years of behavioral health payer contracting experience, including Medicaid MCO enrollment and commercial payer contracting.
• Technical Knowledge: Working knowledge of behavioral health CPT and HCPCS codes, level-of-care billing requirements, and ASAM levels of care.
• Analytical Skills: Demonstrated ability to interpret Medicaid fee schedules, payer policies, and contract provisions to identify reimbursement discrepancies and operational risks.
• Communication: Strong written communication skills, with the ability to deliver clear findings and actionable recommendations within established timelines.
• Independent Work: Ability to prioritize assignments, manage deadlines, and exercise sound judgment within a defined scope focused on contracting, credentialing, and analysis. Claims submission and day-to-day revenue cycle management are outside this role’s scope.
• Preferred Background: Multi-state Medicaid experience and experience supporting a consulting organization, management services organization (MSO), or multiple facilities.
• Meaningful Work: Support an organization committed to ethical, high-quality behavioral health and substance use disorder treatment.
• Flexible Schedule: Work remotely approximately 10 hours per week, with primarily asynchronous responsibilities and occasional scheduled meetings.
• Professional Impact: Apply your expertise to strengthen payer relationships, support reimbursement accuracy, and improve financial and operational performance.
• Compensation: $50 per hour as a part-time W-2 employee.