Job Summary The Billing Credentialing and Operations Support Specialist provides coordinated administrative support across billing, payer and provider credentialing, audit and compliance activities, facilities, and day-to-day operations. The position helps maintain accurate records, complete time-sensitive follow-up, resolve routine discrepancies, and keep administrative workflows organized across company locations. This is a nonclinical support role that works closely with billing, clinical leadership, human resources, scheduling, and operations. Essential Duties and Responsibilities Billing Support Review service documentation, authorizations, client demographics, payer information, and billing data for completeness before claim submission or billing follow-up. Assist with claim creation, submission, correction, resubmission, and status follow-up under established billing procedures. Research routine denials, rejections, unpaid claims, recoupments, and payment discrepancies; document findings and escalate issues requiring payer or leadership intervention. Post, reconcile, or verify payments and adjustments as assigned and maintain accurate accounts receivable notes and work queues. Track authorization dates, units, payer requirements, timely filing limits, and other billing deadlines; notify appropriate team members of risks or missing information. Communicate professionally with payers, families, and internal staff regarding billing questions while protecting confidential information. Prepare billing reports, aging summaries, discrepancy logs, and supporting documentation as requested. Credentialing Support Prepare, submit, and monitor initial credentialing, recredentialing, enrollment, contracting, demographic change, and roster applications for individual providers and organizational locations. Maintain current credentialing files and tracking systems for licenses, certifications, attestations, insurance, background requirements, CAQH profiles, NPIs, taxonomy information, and payer enrollment records. Follow up with providers, licensing bodies, health plans, and credentialing entities to obtain missing information and resolve routine application deficiencies. Track renewal and expiration dates and provide timely reminders and escalation when required items remain outstanding. Verify that payer rosters, service locations, provider affiliations, and effective dates are accurate before billing begins. Maintain organized copies of submissions, confirmations, correspondence, approvals, effective dates, and payer reference numbers. Audit and Compliance Support Assist with internal and external audit preparation by gathering claims, remittance records, authorizations, credentialing files, contracts, session documentation, and other requested supporting records. Perform administrative pre-audit reviews using approved checklists to identify missing signatures, dates, credentials, service details, required forms, or inconsistencies between documentation and billed services. Compare billing records with source documentation and report discrepancies without altering clinical records or making independent clinical determinations. Maintain audit request logs, document indexes, submission trackers, deadlines, findings, corrective action items, and evidence of completion. Support routine monitoring for payer requirements, record-retention practices, privacy safeguards, exclusion checks, training records, and administrative policy compliance as assigned. Protect HIPAA-regulated and other confidential information by following access, storage, transmission, and minimum-necessary standards. Escalate suspected overpayments, duplicate billing, documentation concerns, expired credentials, privacy issues, conflicts, or other potential compliance risks promptly to the designated leader. Assist with policy distribution, staff acknowledgments, compliance reminders, and preparation of responses to audit findings under leadership direction. Do not independently interpret legal requirements, change clinical documentation, direct clinical care, or submit a formal compliance response without authorized review. Facilities Support Receive, document, and route facility repair, maintenance, cleaning, safety, supply, security, access, and equipment requests. Coordinate routine vendor scheduling, obtain information or estimates as directed, confirm access, and track work through completion. Maintain facility logs, inspection records, keys and access records, vendor contacts, warranties, service agreements, and recurring maintenance schedules. Monitor office and clinical supply levels, place approved orders, verify deliveries, and support inventory controls. Assist with office openings, moves, closures, room readiness, signage, records storage, and other facility projects. Report urgent safety, security, accessibility, environmental, or building concerns immediately; this role does not perform licensed repair work. Operational Support Maintain shared trackers, calendars, task lists, standard operating procedures, forms, and administrative records. Support cross-department projects, meeting preparation, data entry, scanning, filing, correspondence, and follow-up activities. Monitor assigned inboxes and work queues, prioritize deadlines, and route requests to the correct team member. Assist with onboarding and offboarding logistics, including administrative checklists, system or building access requests, equipment, and record collection as assigned. Compile operational data and recurring reports for leadership and identify incomplete, delayed, or inconsistent processes. Provide respectful, timely customer service to clients, families, staff, payers, vendors, and community partners. Provide administrative backup coverage and complete other related duties consistent with the role. Performance Expectations Completes assigned submissions, follow-up tasks, and audit requests by established deadlines. Maintains accurate, current, and well-organized records with clear documentation of actions taken and next steps. Uses approved workflows and escalates exceptions, risks, and unresolved discrepancies promptly. Communicates professionally and follows through on commitments across departments and locations. Maintains confidentiality and demonstrates sound judgment when handling financial, personnel, client, and provider information. Contributes to measurable reductions in missing documentation, expired credentials, unresolved work queues, and preventable billing errors. Minimum Qualifications High school diploma or equivalent required; associate degree or relevant postsecondary education preferred. At least two years of administrative experience in healthcare billing, credentialing, revenue cycle, compliance, medical office operations, or a closely related setting preferred. Working knowledge of healthcare claims, payer portals, provider enrollment, authorizations, remittance information, and confidential records preferred. Proficiency with Microsoft 365 and the ability to learn electronic health record, billing, credentialing, and project-tracking systems. Strong attention to detail, organization, follow-through, problem solving, written communication, and professional customer service skills. Ability to manage multiple deadlines, distinguish urgent from routine work, and ask for guidance when authority or requirements are unclear. Ability to pass required background checks and meet company, payer, and regulatory requirements applicable to the position. Preferred Qualifications Experience in behavioral health, applied behavior analysis, pediatric services, Medicaid, TRICARE, or commercial insurance. Experience with CentralReach or a comparable electronic medical record and practice management platform. Familiarity with CAQH, NPPES, PECOS, Availity, payer credentialing portals, audit response preparation, or accounts receivable follow-up. Knowledge of HIPAA, documentation standards, payer contracts, exclusion screening, and healthcare record-retention practices. Core Competencies Accuracy and document control Deadline and priority management Confidentiality and professional judgment Research and discrepancy resolution Cross-functional communication Process consistency and continuous improvement Accountability and reliable follow-through Physical and Work Requirements The employee regularly performs computer-based work, communicates by telephone and electronic systems, and handles paper and electronic records. The role may require moving between work areas, accessing files and supplies, and occasionally lifting or carrying office materials weighing up to 25 pounds. Reasonable accommodations may be provided to enable qualified individuals to perform the essential functions. Some travel between assigned locations or to vendor and payer-related appointments may be required. Supervision and Decision Authority This position does not provide clinical supervision and does not independently determine medical necessity, alter clinical records, approve claims write-offs, interpret contracts or law, authorize facility expenditures, or issue formal compliance conclusions unless separately authorized in writing. The employee is expected to identify concerns, document facts, follow established procedures, and elevate matters to the appropriate leader. Equal Employment Opportunity LEAPS Autism and Behavioral Services is an equal opportunity employer. Employment decisions are made without unlawful discrimination and in accordance with applicable federal, state, and local requirements. Reasonable accommodations are available for qualified applicants and employees as required by law.

Pay:

$47,840.00 - $52,000.00 per year

Benefits:

Health insurance Paid time off Professional development assistance Tuition reimbursement Vision insurance

Work Location:

In person