Medical Billing & Insurance Credentialing Specialist

Nutritional Weight And Wellness

Medical Billing & Insurance Credentialing Specialist

Saint Paul, MN
Full Time
Paid
  • Responsibilities

    Benefits:

    401(k)

    Employee discounts

    Health insurance

    Paid time off

    Company: Nutritional Weight & Wellness Job Type: Full-Time Location: St. Paul, MN (Hybrid)

    First, a little about us. We help people build healthier lives — and we think that starts with our own team. Weight & Wellness is a small, people-first nutrition practice where work/life balance is real, every team member matters, and no one is just a job title. If you've worked at a place where your effort went unnoticed, this will feel different.

    Now, the role. We're bringing insurance billing in-house and need a skilled billing and credentialing specialist to own it. You'll work inside Healthie (EHR) and ClaimMD (EDI) — modern tools that handle a lot of the heavy lifting — but this role still requires a sharp, experienced person who knows how to read a denial, fix a claim, credential a provider, and talk to a client about their benefits without making their eyes glaze over.

    What You'll Own:

    Submitting claims from Healthie to ClaimMD and staying on top of what comes back

    Resolving denied or rejected claims — ClaimMD surfaces the reason codes, you take it from there (corrections, resubmissions, or formal appeals)

    Eligibility verification before appointments — ClaimMD covers most payers; you'll handle the rest through payer portals

    Invoicing clients for copays and coinsurance once the insurance payment is received

    Managing accounts receivable and following up on aging balances

    Tracking referral requirements and coordinating with clients and referring providers when needed

    Handling prior authorizations for the occasional plan that requires it (not common for MNT, but it does come up with some Medicaid and HMO plans)

    Credentialing new providers and keeping everything current — CAQH profiles, revalidations, payer enrollments, expiring documents

    Being the person the front desk staff, clients and providers turn to when they have an insurance question — and actually helping them understand the answer

    What We're Looking For:

    4+ years of medical billing experience (nutrition or wellness setting is a bonus)

    ClaimMD or equivalent clearinghouse experience

    Solid CPT/ICD-10 coding knowledge, especially MNT codes (97802, 97803, 97804)

    Credentialing experience — CAQH, payer enrollment, the whole process

    Comfortable with payer portals (Availity, NaviNet, etc.)

    A communicator who can explain insurance in plain English

    Someone who runs their own work, hits their own deadlines, and doesn't need to be managed

    What You'll Get:

    A team that actually respects your personal time

    Recognition for the work you do — in a small practice, good work doesn't go unnoticed

    Room to make this role your own and improve how things run

    Competitive pay based on your experience

    Health Insurance, Paid Time Off, 401K, Life Insurance, Employee Discount

    Ready to apply? Send your resume and why you think you're a good fit for the role.

    Flexible work from home options available.