Medical Billing Specialist / Lead

This is a single opening. We are hiring at either the Specialist or Lead level depending on the experience the right candidate brings. Level and compensation are determined during the interview process.

Who We Are

Counseling Works is a thriving private therapy practice with offices in Naperville, Frankfort, Lemont, and Shorewood, Illinois. We are an established group practice with a strong reputation, serving adolescents, adults, and couples across a team of roughly 50 clinicians.

As an organization, we place focus not only on our clients but on our professionals as well. With openness and collaboration at our core, we recognize the needs of our employees and work to create a positive work-life balance.

The Role

We are looking for an experienced medical biller to take on the most technical work in our revenue cycle: claims, ERA processing, denials, coding accuracy, and provider credentialing across roughly 50 clinicians and seven payer families.

Our billing function is in good shape and we want to keep it that way. Insurance AR over 90 days currently sits under 5% of total AR, well ahead of benchmark for a practice our size. You would join a three-person billing team covering eligibility and benefits, patient payments and collections, and claims and AR.

We are posting this role at two levels because we would rather find the right person than fill a fixed title:

• Billing Specialist — you own the day-to-day billing, coding, and credentialing work, reporting directly to the Director of Operations, who handles department oversight. No supervisory responsibility. If you are newer to credentialing, this is a role you can grow into with support.
• Billing Lead — you own all of the above and additionally take on department performance, team coordination, payer relationships, and process documentation.

If you are strong on the technical side and would rather not manage people, apply at the Specialist level. If you have led a billing function and want to own outcomes, apply at the Lead level. If you are unsure which fits, apply anyway and tell us what you have owned — we will find the right level together.

What You’ll Own

The following applies at both levels.

Claims and payment processing

• Manage the full billing cycle in TherapyNotes — charge entry, claim scrubbing, batch submission, resubmission, and claim holds
• Process ERAs and EOBs; post insurance payments, adjustments, and denials on a timely cycle and reconcile against deposits
• Manage payer and code configuration in the practice management system

Accounts receivable and denials

• Manage insurance accounts receivable, including aging review and resolution of unpaid and underpaid claims
• Research and resolve denials, distinguishing coding, eligibility, authorization, and provider-enrollment causes and routing each accordingly
• File and track appeals through resolution
• Identify recurring denial causes and recommend process changes that prevent them

Coding and documentation accuracy

• Review CPT and ICD-10 coding on outpatient behavioral health claims for accuracy and payer-specific requirements
• Apply and verify modifiers, place-of-service codes, and telehealth coding correctly
• Identify coding-related denial patterns and work with clinicians and client care to correct them at the source
• Keep current on coding updates and payer policy changes affecting behavioral health services

Credentialing and insurance contracting

• Assist with provider credentialing and re-credentialing
• Maintain provider credentialing files and deadlines
• Complete and maintain CAQH profiles
• Submit and track applications with commercial insurance payers
• Assist with payer enrollment and contracting
• Monitor credentialing status and follow up with insurance companies as needed
• Maintain accurate records of provider licenses, certifications, malpractice insurance, NPI information, and other credentialing documentation
• Assist with adding new clinicians to existing insurance contracts

Collaboration and reporting

• Act as a point of contact for clients, clinicians, client care, and the admin team; triage and resolve billing questions in collaboration with the team, representing the company voice at all times
• Report on assigned scorecard measures, including proactive steps for any measure under target
• Document the workflows you own so they are transferable, and cross-train teammates on your core functions
• Maintain strict confidentiality of protected health information and full HIPAA compliance in all work

Additional Responsibilities at the Lead Level

• Own credentialing and payer enrollment end to end, including the re-credentialing and revalidation calendar, payer roster reconciliation, and contract-level questions
• Provide direct supervision to billing team members; Coordinate daily workflows and manage resource allocation alongside workload distribution
• Own the billing department scorecard and report performance, trends, and risks to the Director of Operations
• Serve as the lead escalation path for billing issues raised by clinicians, client care, and the admin team
• Own payer relationships and escalations, including provider representative contacts and recurring-issue resolution
• Conduct root-cause analysis on denial trends and drive corrective action upstream in the process
• Own and enforce billing and credentialing standard operating procedures across the department
• Contribute to onboarding and cross-training so that no function in the department sits with only one person

What You Bring

Required at both levels

• EHR fluency; TherapyNotes experience strongly preferred
• Strong working knowledge of CPT and ICD-10 coding
• Working knowledge of HMO/PPO, Medicare, Medicare Advantage, Medicaid managed care, and commercial payer requirements
• Demonstrated ability to work ERAs, denials, and appeals independently, without day-to-day direction
• Advanced organizational skills; able to prioritize and hold multiple deadlines without being reminded
• Proficiency with Excel and Google Workspace (Gmail, Docs, Sheets, Forms)
• Working knowledge of the mental health field, PHI confidentiality, and HIPAA compliance
• Prior experience in a patient- or client-facing support role
• Resourceful, self-directed, a proactive communicator, and team-oriented
• Warm, empathetic, positive, thoughtful, and friendly demeanor
• Passion for supporting mental health and the community

Experience

• Billing Specialist: 3+ years of medical billing and collections experience. Credentialing experience is strongly preferred; willingness to learn it is required.
• Billing Lead: 5+ years of medical billing and collections experience, including hands-on credentialing and experience directing the day-to-day activities of a billing team or function

Preferred

• Hands-on provider credentialing experience, including CAQH profile management and commercial payer applications — required at the Lead level
• Behavioral health or multi-site group practice billing experience
• Experience with supervisory billing arrangements for pre-licensure clinicians
• Experience managing Blue Cross Blue Shield of Illinois enrollments and escalations
• Medicare enrollment and PECOS experience
• Experience reporting departmental metrics to leadership

Licenses and certifications

• Certified Medical Biller — CPB, CMRS, or equivalent (required at the Lead level, strongly preferred at the Specialist level)
• Coding certification — CPC, CCS, or equivalent (preferred)
• Credentialing certification — CPCS or equivalent (preferred)

Education

• Minimum of a high school diploma or equivalent
• Associate’s degree in healthcare, business, office administration, or a related field preferred

Schedule and Location

Work location: Fully remote

Schedule: 30 hours per week, with flexible scheduling within our core business hours (Monday through Friday; Central Standard Time Zone).

Reports To: Director of Operations (located in Illinois)

Compensation and Benefits

Pay scale:

• Billing Specialist: $25.00 – $30.00 per hour 
• Billing Lead: $32.00 – $38.00 per hour 
• These ranges are intentionally broad. Placement reflects years of experience, certification, depth of behavioral health credentialing and coding experience, and demonstrated ability to work denials and payer escalations independently. We are prepared to pay at the top of the applicable range for a candidate who brings all of it.

Benefits and other compensation:

• Health, dental, and vision insurance
• Life insurance and disability plans covered 100% by employer
• 401k with employer matching
• PTO, vacation & sick time
• Flexible schedule
• Fully remote work