Remote Payer Contracting & Credentialing Pro

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

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