ABA Certification Manager

1 week ago

Rizal, Philippines beBeeCredentialing Full time ₱7,200 - ₱7,800
Job Title: Credentialing Professional

We are seeking a skilled Credentialing Specialist to manage credentialing and re-credentialing processes for clinicians and facilities.

  • The ideal candidate is well-versed in payer enrollment requirements, particularly for ABA providers, and can navigate commercial and Medicaid insurance portals with ease.
  • Ensure that all clinicians are properly credentialed and compliant, allowing uninterrupted service delivery and reimbursement.

Key Responsibilities:

  • Complete and maintain credentialing and re-credentialing applications for BCBAs, RBTs, and other ABA clinicians.
  • Submit applications to commercial and Medicaid payers, including CAQH, NPI, PECOS, and individual payer portals.
  • Track credentialing statuses, follow up on delays, and maintain regular communication with insurance companies.
  • Maintain up-to-date records of licensure, certifications, background checks, liability insurance, and other compliance documentation.
  • Coordinate start dates with HR and scheduling teams to ensure clinicians are active before seeing clients.
  • Ensure accuracy and timely submission of demographic updates, reassignment of benefits, and provider termination notices.
  • Monitor credentialing expiration dates and initiate renewals in advance.
  • Assist billing team with credentialing-related claim denials and payer issues.
  • Stay updated with payer policy changes and credentialing guidelines, especially those impacting ABA services.

Requirements:

  • Credentialing experience, preferably in ABA or behavioral health.
  • Strong knowledge of credentialing processes and insurance requirements (Medicaid, private payers, CAQH, etc.).
  • Familiarity with BACB and state licensing requirements for ABA professionals.
  • Excellent organizational and time management skills.
  • Strong written and verbal communication skills.
  • Proficiency with EMR systems like CentralReach, Rethink, or Catalyst.
  • Ability to manage sensitive information with a high level of confidentiality and accuracy.
  • Knowledge of ABA-specific billing and compliance processes.

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