Are you highly organized, detail-oriented, and experienced in navigating the ins and outs of medical billing and credentialing? If so, you might be the perfect fit for our team at UNIFI!
We’re looking for a Billing and Credentialing Specialist who’s not just great with numbers and paperwork—but someone who’s excited to play a key behind-the-scenes role in helping our clinical teams deliver life-changing ABA therapy. From submitting claims and verifying insurance to keeping our providers credentialed and ready to go, you’ll be the go-to person for all things billing and enrollment.
If you enjoy solving puzzles, staying ahead of deadlines, and working in a collaborative, mission-driven environment, we’d love to hear from you!
Billing Responsibilities
- Process and submit insurance claims for ABA services accurately and in a timely manner
- Verify insurance eligibility and benefits for patients receiving ABA therapy
- Follow up on outstanding claims, denials, and appeals with insurance companies
- Post payments and adjustments to patient accounts
- Generate and analyze billing reports to identify trends and areas for improvement
- Maintain compliance with billing regulations including HIPAA and payer-specific guidelines
- Communicate with families regarding billing questions, statements, and payment arrangements
- Coordinate with clinical staff to ensure accurate service documentation for billing purposes
- Confidentiality: Maintain confidentiality per UNIFI policy and HIPAA
- Compliance: Follow all regulations and guidelines
Credentialing and Enrollment Responsibilities
- Manage the credentialing and re-credentialing process for BCBAs, RBTs, and other clinical staff
- Submit provider enrollment applications to insurance panels (Medicaid, commercial insurance, etc.)
- Track credentialing timelines and ensure renewal deadlines are met
- Maintain accurate credentialing files and database records
- Respond to credentialing verification requests and audits
- Stay current on payer-specific credentialing requirements and policy changes
- Coordinate with providers to obtain necessary documentation, licenses, and certifications
- Process CAQH profile updates and monitor for accuracy
Knowledge, Skills, and Abilities
- Understanding of insurance verification, authorization processes, and claims management
- Knowledge of CPT codes specific to ABA therapy (97151, 97152, 97153, 97155, 97156, 97157, 97158)
- Strong problem-solving abilities and persistence in resolving billing issues
- High level of professionalism when interacting with insurance companies, families, and colleagues
- Ability to maintain confidentiality and handle sensitive information
- Time management skills with ability to meet deadlines
- Adaptability to changing insurance policies and regulations
- Team player with collaborative approach
- Proficiency with medical billing software, Excel, Microsoft Office, data analysis and medical billing terminology
Experience and Education
- High school diploma or equivalent; Associate's or Bachelor's degree preferred
- Minimum of two years of experience in medical billing, credentialing, and provider enrollment processes preferably in behavioral health or ABA services
Work Environment
The Billing and Credentialing Specialist role is entirely remote. Candidates must reside within the Eastern Standard Time Zone.
Physical Requirements
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential duties of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform essential duties.
While performing the duties of the position, the Billing and Credentialing Specialist must be able to operate standard office equipment and keyboards and talk and hear (both in-person and by telephone). The person in this position must be able to effectively work on a computer for prolonged periods of time.
Travel
The Billing and Credentialing Specialist may occasionally travel for in-person meetings, conferences, or training. Travel time will be paid for by UNIFI. Mileage can be expensed.
- Enjoy a generous time-off package with 24 total days annually: 15 days of Paid Time Off (PTO) and 9 paid holidays for work-life balance.
- Comprehensive medical, dental, and vision insurance.
- 401(k) plan with company match for your future.
- Extensive ongoing professional development and support.
- A Monday through Friday schedule
