Credentialing specialist Jobs in Augusta, GA

Job Description

Job Description

About Us :

Evolve is a trusted psychiatric and behavioral health service provider committed to delivering high-quality mental health care to our patients. We are seeking an experienced Mental Health Billing Specialist with expertise in denials management, insurance credentialing, verification , and experience with eClinical Works . This role is essential to ensuring the financial success of our practice and the accessibility of care for our patients.

Position Overview :

The Mental Health Billing Specialist will be responsible for managing claim denials, appeals, insurance credentialing, and verification processes . The ideal candidate has a strong background in medical billing within a behavioral health setting, excellent problem-solving skills, and a deep understanding of HCA Clinical Works .

Key Responsibilities :

Billing & Denials Management :

• Review, analyze, and resolve denied or underpaid claims in a timely manner.
• Prepare and submit appeals for denied claims, ensuring compliance with payer guidelines.
• Track and follow up on outstanding claims, correcting errors to secure payment.
• Work closely with insurance companies to identify trends in denials and implement corrective actions.

Insurance Credentialing & Verification :

General Billing & Compliance :

Qualifications & Experience :

Preferred Qualifications :