Billing & Credentialing Specialist

Clarity Clinic is a multidisciplinary group practice of Psychiatrists, Psychiatric Advanced Practice Providers, Psychologists, and Therapists. Our mission is to thoughtfully guide the whole person on their journey to find clarity and mental wellness by providing exceptional holistic care. Our staff of Psychiatrists, Advanced Practice Providers and Psychotherapists offer the latest medication, psychological assessment, and therapy treatment as we help guide our patients toward mental wellness and a balanced personal and professional lifestyle. Our team offers a broad range of specialties, services, and orientations to support and help guide our clients through their wellness journey. We offer a variety of services including TMS (Transcranial Magnetic Stimulation), Medication Management, Psychological Testing and Therapy. 

Location: Fully remote within the state of Illinois 

In this role, you will: 

• Support the re-credentialing and CAQH attestation process by verifying provider profiles and supplying necessary documentation for successful completion.
• Assist in the collection and organizing of information from providers, malpractice, and other sources to support the credentialing application process.
• Facilitate the acquisition and renewal of provider licenses—including Professional, DEA, and Controlled Substance licenses—to ensure providers remain compliant with federal, state, and payer regulations.
• Collaborate with the Director of Reimbursement and billing staff to identify and resolve issues related to provider credentialing, such as denials or authorization challenges.
• Track and monitor credentialing statuses for all providers, ensuring updates are communicated and actioned promptly.
• Act as a liaison between providers and credentialing agencies or insurance providers, ensuring all required documentation is submitted accurately and promptly.
• Scan and organize documents received from various departments to ensure easy access and reference.
• Retrieve and provide documentation as requested by office staff to support operations.
• Develop and oversee claim edits for newly onboarded providers.
• Support Billing by managing claim inspector edits to streamline claim processing.
• Assist Billing with self-pay charges to ensure precise charging and thorough service documentation.
• Assist Billing in verifying service locations to ensure accurate processing of in-office and virtual claims.
• Assist in the management of accurate and timely billing of specialized claims that related to but are not limited to: Self-pay, No Show, Psych Testing and IOP/PHP claims.
• Assist the Director in resolving claim edits to maintain an average clean claim rate of 97% or higher, in alignment with MGMA's billing metrics.
• Serve as liaison between the provider and PayrHealth during the credentialing process

Benefits and Perks:   

• Compensation: $23.07 per hour- $31.25 per hour commensurate to years of experience. 
• Comprehensive benefits package including health, dental vision, EAP services and more. 
• 10 days of PTO (80 hours) plus up to 5 accrued sick/wellness days.
• Wellness Stipend reimbursement to support your own self-care routine!
• 6 Company holidays
• 401k match up to 4%.

Qualifications:

• High School Diploma
• Minimum of ​2 years’ experience in healthcare billing and credentialing preferred
• Minimum of ​2​ years of experience with CMS-1500 (02/12) charge entry, coding, and batch filing.
• Knowledge of CPT and ICD coding along with medical terminology.
• Extremely detail oriented with a high level of problem-solving skills.

Please stay alert to protect yourself from sophisticated job scams during the recruiting process. Only emails that come from claritychi.com are legitimate recruiting messages. Our HR Team will not send emails from other domains or communicate using the WhatsApp messaging platform or text messaging. We conduct all interviews by phone or video, and we will never ask you for money or to download software either during the interview process, credentialing or during our onboarding process. More tips from the FTC to avoid job scams: https://www.consumeraffairs.com/news/ftc-offers-tips-on-avoiding-job-scams-041321.html