Medical Credentialing & insurance contracting Specialist -Behavioral Health

Medical Credentialing & Insurance Contracting Specialist – Behavioral Health
Company: ClaimWise Billing Solutions
Job Type: Remote
Experience Level: Expert – Experienced Professionals Only
Job Description
ClaimWise Billing Solutions is seeking a highly experienced Medical Credentialing & Insurance Contracting Specialist to help our behavioral health clients obtain in-network contracts with commercial insurance companies, Medicaid, and Medicare.
This position focuses on securing individual provider, group practice, and facility-level insurance contracts, managing the entire process from initial application through contract execution and confirmed in-network status.
We are looking for a self-motivated professional who takes their work seriously, requires minimal supervision, and consistently follows through to completion.
This is not an entry-level position. Prior credentialing and insurance contracting experience is mandatory.
Key Responsibilities

Secure in-network insurance contracts for individual providers, group practices, and behavioral health facilities.

Manage credentialing, enrollment, and contracting applications from start to finish.

Work directly with insurance company credentialing and contracting departments.

Handle enrollment and contracting for RTC, PHP, IOP, outpatient mental health, psychiatry, TMS, and other behavioral health services.

Identify payer network requirements and contracting opportunities.

Manage CAQH, PECOS, Availity, and payer-specific enrollment portals.

Coordinate provider affiliations, group enrollments, facility contracts, and service location additions.

Resolve application delays, denials, closed-panel issues, and other contracting obstacles.

Verify contract execution, effective dates, and accurate in-network enrollment.

Maintain organized credentialing trackers and provide regular updates on progress.

Follow up proactively with payers until applications and contracts are finalized.
Required Qualifications

Extensive experience in medical credentialing and insurance contracting.

Proven success securing in-network contracts for providers, groups, or facilities.

Strong knowledge of behavioral health credentialing requirements.

Experience with commercial insurance networks, Medicaid, and Medicare.

Understanding of individual, group, and facility enrollment processes.

Excellent English communication skills, both written and verbal.

Strong organizational skills and exceptional attention to detail.

Ability to manage multiple clients and applications independently.
The Ideal Candidate

Takes ownership of their work and responsibilities.

Is highly motivated, dependable, and professional.

Does not require constant supervision or reminders.

Is proactive, persistent, and resourceful.

Takes deadlines seriously and follows through on commitments.

Communicates clearly and provides updates without being asked.

Approaches challenges with a problem-solving mindset.

Takes pride in producing accurate work and delivering measurable results.
We value accountability, initiative, and a strong work ethic. We want someone who treats our clients' success as a priority, not someone who simply submits applications and waits for responses.
How to Apply
Please submit your resume and answer the following questions:

How many years of medical credentialing and insurance contracting experience do you have?

Have you successfully secured individual, group, and facility-level insurance contracts?

What experience do you have with behavioral health facilities, particularly RTC, PHP, and IOP?

Which commercial insurance payers have you worked with?

Have you independently managed contracting from initial application through confirmed in-network status?

Describe a challenging credentialing or contracting issue you successfully resolved.
Applicants without substantial hands-on credentialing and contracting experience will not be considered.
We are looking for an experienced professional who can independently manage their workload, solve problems, and deliver results for our growing client base.