Job Description

This is a Remote position

About Zealie:

Zealie is a fast-growing Medical Billing Services company specializing in the Behavioral Healthcare industry. Our clients are substance use disorder treatment, addiction recovery, and mental health treatment centers that are saving lives on a daily basis. Our state-of-the-art proprietary technology provides data analytics and revenue prediction tools to our clients to help them make strategic business decisions to grow their business.



We are committed to delivering exceptional products and services to our clients and believe that our Payor Relations team plays a crucial role in achieving this mission. We are seeking motivated individuals with a desire to be part of a winning team.

Job Summary:

Under the supervision of the Payor Relations Team Lead and Payor Relations Manager, the Subject Matter Expert (SME) - Payor Relations Team is responsible for monitoring process workflows, ensuring accuracy and compliance, and providing expert-level support to the Payor Relations team.



The SME plays a critical role in identifying and escalating incorrectly initiated or worked tasks, guiding Payor Relations Specialists toward proper resolution, and maintaining consistency across all Payor Relations processes. This position also supports the Team Lead by assisting with training initiatives, process clarifications, quality oversight, and continuous improvement efforts. The SME serves as a key knowledge resource for the team and contributes to reducing errors, improving turnaround times, and strengthening payer relationships.

Responsibilities and Duties:

Monitor Payor Relations workflows to ensure tasks are initiated, processed, and completed accurately and in compliance with established SOPs Identify, escalate, and redirect incorrectly worked or misrouted tasks initiated by Payor Relations Specialists Act as a subject matter expert for credentialing, contracting, and payer-related processes Support the Payor Relations Team Lead with day-to-day operational needs, escalations, and process guidance Conduct training for new hires to ensure understanding of Payor Relations workflows, tools, and expectations Facilitate follow-up training sessions to address questions, clarifications, or performance gaps Provide recap training sessions for specific request types or complex payer workflows Participate in client meetings related to payer portals, In-Network (INN) applications, and credentialing requirements Work on aged requests, including 180+ day pending items, within the Payor Relations Specialist (PRS) log Ensure timely responses to payer communications, maintaining a standard of responding to payer emails within 2 business days Utilize internal Google spreadsheets, drives, folders, and documents to locate, review, and validate supporting documentation Demonstrate strong customer service skills through effective communication with internal teams, payers, and clients Collaborate closely with the Payor Relations Team Lead, Payor Relations Manager, and other stakeholders to meet project deadlines Maintain confidentiality of all patient and client information to ensure patient rights are protected Perform additional duties as requested by the Management team

Qualifications and Skills:

Strong understanding of credentialing, contracting, and payer enrollment workflows Proven ability to identify process gaps and provide corrective guidance Excellent organizational and analytical skills Strong verbal and written communication skills via phone and email Ability to train, mentor, and support team members effectively Proficiency in Google Products, including Google Workspace, Google Drive, Google Sheets, and Google Docs Ability to navigate multiple technology platforms and software tools Strong multitasking skills with the ability to manage production work, training, and projects simultaneously

Education and Experience:

Bachelor's degree or higher in any stream Minimum

4-5 years of experience

in the credentialing process Minimum

2+ years of experience

in Behavioral Health & Mental Health credentialing Hands-on experience working with payer portals, INN applications, and credentialing documentation

(Preferred):

Extensive knowledge of Behavioral Health and Mental Health credentialing and contracting 5+ years of hands-on ("on paper") experience in credentialing processes Experience as an SME or Senior Credentialing Associate Strong working knowledge of state credentialing guidelines for

CA, AZ, TX, FL, NJ, CO, and HI

Experience managing

25+ clients

simultaneously Experience handling

280+ credentialing requests per week

* Demonstrated ability to reduce errors, improve workflows, and support team performance