McHur Care
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This range is provided by McHur Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range $16.00/hr - $24.00/hr
Position Summary: The Billing & Credentialing Representative supports billing, authorizations, claims follow-up, and provider credentialing/enrollment activities. This role helps ensure services are properly authorized, claims are accurately submitted and resolved, and provider credentials remain current with Texas Medicaid, managed care organizations (MCOs), and related partner requirements.
Key Responsibilities
Billing & Revenue Cycle Support
Obtain and track initial and continued authorizations for services
Prepare, review, and submit claims through payor portals and/or clearinghouses
Post payments and adjustments based on ERAs/EOBs
Research and resolve denials/underpayments; resubmit corrected claims as needed
Monitor aging accounts receivable and work balances to reduce outstanding AR
Communicate with payors regarding coverage, benefits, and claim status
Coordinate with internal teams to resolve billing discrepancies (demographics, insurance, documentation, etc.)
Credentialing & Provider Enrollment – coordinate credentialing and re-credentialing for providers with corporate partners and payors
Prepare and submit enrollment applications for Texas Medicaid and Medicaid MCOs (and other payors as needed)
Maintain provider profiles (e.g., CAQH, NPPES, TMHP, MCO portals)
Track deadlines/expirations and follow up proactively to prevent lapses
Support providers in gathering, completing, and submitting required documentation
Maintain organized digital credentialing and enrollment records
Compliance, Quality & Reporting – follow all applicable federal/state requirements, Texas Medicaid guidance, and Internal policies
Protect PHI and maintain strict confidentiality in accordance with HIPAA
Support audits and provide basic reporting (authorizations, denials, credentialing status, expirations, etc.)
Collaboration & Communication – serve as a point of contact for billing and credentialing questions
Coordinate with payors and external stakeholders as needed
Communicate clearly and professionally with internal teams and providers
Qualifications Required
High school diploma or equivalent
1–3 years of experience in medical or behavioral health billing, revenue cycle, and/or credentialing
Experience with Medicaid, MCOs, and insurance verification/authorization processes
Strong organization, attention to detail, and written/verbal communication skills
Preferred
Associate’s degree or higher in healthcare administration, business, or a related field
Behavioral health and/or Texas Medicaid experience
Credentialing/provider enrollment experience (e.g., CAQH, TMHP, MCO portals)
Skills & Competencies
Working knowledge of billing concepts (CPT/HCPCS, modifiers, EOB/ERA, denials, adjustments)
Proficiency with Microsoft Office and practice management/EHR systems
Ability to manage multiple priorities, meet deadlines, and work with minimal oversight
Strong customer service mindset and professional communication
High integrity and consistent handling of sensitive/confidential information
Seniority level Entry level
Employment type Full-time
Job function Accounting/Auditing and Finance
Industries Mental Health Care
Referrals increase your chances of interviewing at McHur Care by 2x
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This range is provided by McHur Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range $16.00/hr - $24.00/hr
Position Summary: The Billing & Credentialing Representative supports billing, authorizations, claims follow-up, and provider credentialing/enrollment activities. This role helps ensure services are properly authorized, claims are accurately submitted and resolved, and provider credentials remain current with Texas Medicaid, managed care organizations (MCOs), and related partner requirements.
Key Responsibilities
Billing & Revenue Cycle Support
Obtain and track initial and continued authorizations for services
Prepare, review, and submit claims through payor portals and/or clearinghouses
Post payments and adjustments based on ERAs/EOBs
Research and resolve denials/underpayments; resubmit corrected claims as needed
Monitor aging accounts receivable and work balances to reduce outstanding AR
Communicate with payors regarding coverage, benefits, and claim status
Coordinate with internal teams to resolve billing discrepancies (demographics, insurance, documentation, etc.)
Credentialing & Provider Enrollment – coordinate credentialing and re-credentialing for providers with corporate partners and payors
Prepare and submit enrollment applications for Texas Medicaid and Medicaid MCOs (and other payors as needed)
Maintain provider profiles (e.g., CAQH, NPPES, TMHP, MCO portals)
Track deadlines/expirations and follow up proactively to prevent lapses
Support providers in gathering, completing, and submitting required documentation
Maintain organized digital credentialing and enrollment records
Compliance, Quality & Reporting – follow all applicable federal/state requirements, Texas Medicaid guidance, and Internal policies
Protect PHI and maintain strict confidentiality in accordance with HIPAA
Support audits and provide basic reporting (authorizations, denials, credentialing status, expirations, etc.)
Collaboration & Communication – serve as a point of contact for billing and credentialing questions
Coordinate with payors and external stakeholders as needed
Communicate clearly and professionally with internal teams and providers
Qualifications Required
High school diploma or equivalent
1–3 years of experience in medical or behavioral health billing, revenue cycle, and/or credentialing
Experience with Medicaid, MCOs, and insurance verification/authorization processes
Strong organization, attention to detail, and written/verbal communication skills
Preferred
Associate’s degree or higher in healthcare administration, business, or a related field
Behavioral health and/or Texas Medicaid experience
Credentialing/provider enrollment experience (e.g., CAQH, TMHP, MCO portals)
Skills & Competencies
Working knowledge of billing concepts (CPT/HCPCS, modifiers, EOB/ERA, denials, adjustments)
Proficiency with Microsoft Office and practice management/EHR systems
Ability to manage multiple priorities, meet deadlines, and work with minimal oversight
Strong customer service mindset and professional communication
High integrity and consistent handling of sensitive/confidential information
Seniority level Entry level
Employment type Full-time
Job function Accounting/Auditing and Finance
Industries Mental Health Care
Referrals increase your chances of interviewing at McHur Care by 2x
#J-18808-Ljbffr