Nutritional Weight And Wellness
Medical Billing & Insurance Credentialing Specialist
Full Time • Hybrid - US
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:
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Day-to-Day:
- Reviewing claims that Healthie auto-generates from appointments, then submitting them to ClaimMD — claim status updates automatically from there as remittances come in
- Eligibility verification before appointments — ClaimMD covers most payers automatically; you'll handle the small number of exceptions through payer portals
- Sending copay/coinsurance invoices once insurance remittance posts — amounts are pre-populated from the claim, not calculated by hand
- Being the go-to person for front desk staff, clients, and providers when an insurance question comes up — and actually helping them understand the answer
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As-Needed:
- Correcting and resubmitting denied or rejected claims using the reason codes ClaimMD surfaces (occasional formal appeal for more complex cases)
- Periodic follow-up on aging accounts receivable balances
- Tracking referral requirements and coordinating with clients and referring providers when it comes up
- Handling prior authorizations for the occasional plan that requires one (not common for MNT, but it does come up with some Medicaid and HMO plans)
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Ongoing (not appointment-driven):
- Credentialing new providers and keeping everything current — CAQH profiles, revalidations, payer enrollments, expiring documents
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.
Compensation: $24.00 - $28.00 per hour
(if you already have a resume on Indeed)