Billing & Credentialing Specialist (Medicaid MCO) – Contract

Job Type: Independent Contractor / Part-Time Contract
Location: Remote (Ohio preferred)
Start: Immediate

About Us

Peer Life LLC is a growing behavioral health agency serving Ohio Medicaid Managed Care populations. We are expanding our revenue cycle operations and seeking an experienced Billing & Credentialing Specialist to support claims management, provider enrollment, and payer compliance.

We are looking for a professional who can help ensure clean claims, accurate provider setup, and efficient reimbursement across multiple Medicaid MCOs.

Position Overview

This role is responsible for managing the full billing lifecycle, including claim submission, denial resolution, provider enrollment accuracy, and payer communication.

The ideal candidate understands Medicaid Managed Care billing rules and can independently resolve complex claim issues such as taxonomy mismatches, enrollment errors, and denial codes.

Responsibilities

• Submit and manage Medicaid MCO claims (837/835 workflows)
• Track and resolve denied or rejected claims
• Correct billing issues including taxonomy, NPI, eligibility, and enrollment errors
• Maintain provider enrollment accuracy (NPI, taxonomy, CAQH when applicable)
• Work within TherapyNotes or similar EHR billing systems
• Monitor ERA/EOB payments and reconciliation
• Communicate with payers regarding claim status and issues
• Identify and resolve recurring denial patterns
• Support credentialing and provider enrollment updates as needed

Requirements

• Strong experience with Medicaid Managed Care billing (Ohio strongly preferred)
• Proven ability to resolve claim denials and billing errors independently
• Strong understanding of NPI, taxonomy, and provider enrollment systems
• Experience with billing systems (TherapyNotes or similar preferred)
• Knowledge of claim lifecycle and clearinghouse processes
• Ability to interpret denial codes and correct root causes
• Strong attention to detail and analytical skills

Preferred Qualifications

• Experience with Ohio Medicaid MCOs (CareSource, Molina, AmeriHealth, Humana, etc.)
• Behavioral health billing experience (peer support or outpatient services preferred)
• Credentialing or CAQH management experience
• Familiarity with denial codes such as taxonomy (Code 145) and eligibility errors
• Experience working with multiple payers simultaneously

Engagement Structure

• Long-term independent contractor opportunity
• Flexible remote work arrangement
• Ongoing billing volume based on payer activity
• Opportunity for consistent monthly work for qualified professionals

Compensation structure will be discussed during interview based on experience and scope of support.

How to Apply

Please send:

• Resume
• Summary of Medicaid billing experience
• List of MCOs worked with
• Examples of denial issues resolved

Pay: From $35.00 per hour

Application Question(s):

• Can you handle Medicaid MCO billing?
• Can you fix denials?
• Do you understand 837/835 workflows?

Work Location: Remote