We invest in the whole family's right to self-determination by providing meaningful, individualized, and culturally relevant behavioral services. We affirm children, teens, and young adults who exhibit social, emotional, learning, and behavioral concerns using the science of Applied Behavior Analysis(ABA) with a strengths-based and trauma-informed approach. We not only uplift the children and teens we service through ABA, but empower parents and siblings of our disabled and/or neurodivergent clients with the common goal of enhancing the quality of life for the entire household through the provision of mental health services, parent guidance, advocacy tools, and group sessions. Our Guiding Values: Sustainability- We strive to ensure every person learns strategies they can continue long after our extensive work together Integrity- We strive to exhibit high-quality ethical services, adhering to the standards set forth by our governing body and the population we service Growth- We strive to increase meaningful skills for our clients to thrive within their own environments Nurturance- We strive to provide a learning environment in which our clients feel cared for, heard, and prioritized Autonomy- We strive to support our client’s freedom of choice and independence Trust- We strive to create a trusting relationship with our clients while overseeing their advancements Unity- We strive to maintain a collaborative working relationship, placing emphasis on the team effort that is necessary to accomplish meaningful change Responsiveness- We strive to produce culturally responsive care that respects and acknowledges the identities and values that are important to our clients Empowerment- We strive to encourage clients to become the #1 advocate for their own progress

Revenue Cycle & Credentialing Specialist

Job Type: Full-Time or Part-Time

Compensation: $30.00–$42.00/hour (commensurate with experience)

Who We Are

At Sankofa Behavioral Health, we believe that quality clinical care begins with strong operational systems. Our mission is to provide culturally grounded, clinically sound behavioral health services that improve the lives of children, families, and communities.

Our mantra is Joy First, Data Second.

Our motto is Culturally Grounded. Clinically Sound.

We provide ABA therapy, mental health counseling, psychological evaluations, and caregiver support through a collaborative, interdisciplinary approach. As our organization continues to grow, we are seeking an experienced Revenue Cycle & Credentialing Specialist to help ensure our financial operations remain efficient, compliant, and sustainable.

If you enjoy solving complex billing challenges, maximizing reimbursement, and improving systems, we'd love to meet you.

What We Offer

• Meaningful work that directly supports access to care
• Competitive compensation based on experience
• Collaborative, mission-driven culture
• Flexible scheduling options
• Employee Assistance Program (EAP)
• Mental health counseling
• Life coaching
• Work/life resources
• Medical advocacy
• Legal and financial resources

For employees working 30+ hours/week:

• Company-subsidized health insurance
• Dental insurance
• Vision insurance
• Life insurance
• Paid Time Off
• Paid Holidays
• 401(k) with 3% employer contribution

Position Summary

The Revenue Cycle & Credentialing Specialist is responsible for overseeing the organization's revenue cycle from insurance verification through final payment.

This position serves as the primary expert in behavioral health billing, credentialing, authorizations, payer relations, and reimbursement. The ideal candidate is proactive, detail-oriented, and committed to identifying opportunities to improve cash flow while maintaining compliance with payer requirements.

This position works closely with clinical leadership and administration to ensure services are billed accurately, authorizations remain current, providers remain credentialed, and reimbursement is maximized.

Essential Responsibilities

Revenue Cycle Management

• Own the revenue cycle from claim submission through payment resolution.
• Submit electronic and paper insurance claims accurately and timely.
• Monitor claim status and resolve rejected, denied, and pending claims.
• Prepare and submit appeals when appropriate.
• Post insurance and client payments accurately.
• Maintain low accounts receivable aging through proactive follow-up.
• Identify billing trends and recommend process improvements.
• Monitor payer turnaround times and reimbursement trends.

Insurance & Authorizations

• Verify client insurance eligibility and benefits.
• Obtain and track authorizations.
• Monitor authorization utilization and notify clinical staff of upcoming expirations.
• Coordinate with clinical staff to ensure uninterrupted services.

Credentialing

• Complete initial provider credentialing.
• Manage recredentialing deadlines.
• Maintain CAQH profiles.
• Complete Medicaid enrollment and revalidation.
• Maintain provider records with commercial insurance companies.
• Submit Single Case Agreements when applicable.

Financial Operations

• Generate monthly revenue reports.
• Monitor billing metrics and key performance indicators.
• Track Days in Accounts Receivable.
• Track clean claim rates.
• Track denial rates.
• Reconcile outstanding balances.
• Assist leadership with revenue forecasting.
• Recommend workflow improvements that increase reimbursement and efficiency.

Compliance

• Maintain compliance with HIPAA regulations.
• Maintain accurate documentation supporting claims.
• Ensure adherence to payer guidelines and state/federal regulations.
• Participate in internal audits and quality improvement activities.

Qualifications

Required

• Minimum 5 years of behavioral health and/or ABA billing experience
• High school diploma or GED
• Experience with Medicaid and commercial insurance billing
• Experience with provider credentialing
• Strong understanding of revenue cycle management

Preferred

• Certified Professional Biller (CPB) or equivalent certification
• Experience with ABA billing
• Experience with mental health billing
• Maryland Medicaid billing experience
• Experience with TherapyPM or similar practice management software
• Experience with clearinghouses and electronic claim submission

Knowledge

Strong knowledge of:

• CPT coding
• ICD-10 diagnosis coding
• ABA billing codes
• Behavioral health billing regulations
• HIPAA
• Medicaid regulations
• Commercial insurance requirements
• Authorizations
• Appeals
• Credentialing processes
• CAQH
• EFT and ERA enrollment

Skills & Abilities

The successful candidate will demonstrate the ability to:

• Analyze complex billing issues and develop solutions.
• Work independently with minimal supervision.
• Prioritize multiple deadlines effectively.
• Maintain exceptional attention to detail.
• Communicate professionally with insurance representatives, providers, families, and staff.
• Handle confidential information appropriately.
• Identify operational inefficiencies and recommend improvements.
• Collaborate effectively across departments.

Success in This Role

At Sankofa, we are looking for someone who takes ownership—not just of tasks, but of outcomes.

Success in this role means:

• Protecting the financial health of the organization.
• Maximizing reimbursement while maintaining compliance.
• Identifying problems before they become crises.
• Building systems that improve efficiency.
• Partnering with leadership to ensure sustainable growth.
• Helping families access services by removing administrative barriers.

Other Requirements

• Reliable transportation
• Successful completion of background check
• Satisfactory references
• Strong record of professionalism, reliability, and integrity

Why Sankofa?

We're looking for more than someone who knows how to submit claims.

We're looking for someone who understands that every correctly processed authorization, every successful appeal, and every accurately submitted claim helps ensure that children and families continue receiving the care they deserve.

If you're passionate about operational excellence and want to play a meaningful role in a growing, mission-driven organization, we'd love to hear from you.