Billing Configuration Specialist

Implementation Rockville, Maryland


Qualifacts and Credible, two leading providers of Electronic Health Records (EHR) and related technology to behavioral health and human services agencies, merged in August 2020. The new entity combines and brings to market the decades of experience each company achieved individually, and is laser-focused on helping agency partners improve clinical outcomes, enhance operations, and create healthier communities. The company is offering, enhancing, and fully supporting both EHR platforms – CareLogic and Credible – while collaborating to build an even brighter future for partner agencies and their clients.

If you are interested in combining a mission driven position with a dynamic, results oriented culture, please apply today!

Duties and Responsibilities of the Billing Configuration Specialist

  • Responsible for coordinating and completing implementations billing module, working closely with our partners to understand their billing needs to configure the software application for successful adjudication of claims, as well as, developing creative solutions for partners’ payer requirements.
  • Deliver billing module training sessions pre and post go live. Train new users on the configuration, billing workflows, and Credible claim cycle prior to transitioning to Partner Support.
  • Facilitate payer testing to ensure a successful go-live including troubleshooting configuration and 837 EDI claim files as applicable.
  • Understand how to read and interpret EDI files.
  • Understand and consistently apply Credible’s Best Practice workflows for pre-billing, batching, and posting.
  • Understand and consistently apply Credible’s Best Practices for billing configuration and testing.
  • Must be able to self-manage and prioritize multiple tasks in a fast paced, deadline driven environment.
  • Confidence in dealing with and serving partners.
  • Maintains confidentiality; adheres to all HIPAA guidelines/regulations
  • Learn and develop a thorough understanding of Credible software. Completion of Qualifacts and Credible’s product knowledge and training.
  • Complete New Employee Orientation program.
  • 25-50% Travel required.
  • Additional duties as assigned.

Experience of the Billing Configuration Specialist

  • Previous medical billing experience along with knowledge of billing related reporting; 3 - 5 years’ experience in Behavioral health-care billing & collection practices.
  • Experience working with medical payers such as Medicare, Medicaid, commercial insurances.
  • Working knowledge of medical billing systems/softwares.
  • Experience with Medicaid’s State Eligibility Systems (various states).
  • Working knowledge of CPT and ICD-9/ICD-10 coding systems; Coding certification preferred.
  • BA/BS preferred.
  • Excellent organizational skills.
  • Proficiency in Microsoft Office Suite.

Qualifacts+Credible is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law.