Senior Medical Billing & Credentialing Consultant for Behavioral Health Practice

Hope Bridge Agency is seeking a Senior Medical Billing and Credentialing Consultant with behavioral health/PMHNP experience for a contract-to-hire role. The purpose of this engagement is to participate in a discovery meeting with a psychiatric practice in Jacksonville, Florida, assessing their credentialing readiness and billing capabilities. The consultant will guide the practice on insurance panel enrollment, timelines, and billing setup. Successful engagement may lead to a long-term contract or employment.

Client: Behavioral health practice seeking in-network status with Florida Blue, UnitedHealthcare, and other commercial payers. There is potential for future multi-state expansion. The practice has an NPI Type 2 established.

Discovery Meeting Role:
Represent Hope Bridge as a credentialing and billing expert.
Evaluate documentation and credentialing readiness.
Identify payer enrollment barriers.
Outline enrollment strategy and timelines.
Provide guidance on billing readiness.

Core Responsibilities (if contracted):
Submit and manage provider/group credentialing.
Maintain CAQH ProView, NPPES, and payer profiles.
Track approvals, deficiencies, and recredentialing.
Set up billing, eft/era, taxonomy, and electronic claims.
Advise on behavioral health payer requirements.

Qualifications:
Experience credentialing PMHNP/behavioral health providers with Florida commercial payers.
Knowledge of caqh, nppes, pecos, and payer portals.
Understanding of individual vs group enrollment and NPI Type 1/2 relationships.
Strong communication skills to explain complex processes.

Preferred Qualifications: Telehealth, multi-state credentialing, Medicaid/Medicare experience, and revenue cycle knowledge.

Engagement: Phase 1 involves the discovery meeting; Phase 2 will be a long-term contract/employment if the client contracts. Compensation includes paid consultation and competitive ongoing pay.