Certified Clinical Specialist

1 week ago

Hagonoy, Central Luzon, Philippines beBeeCredentialing Full time ₱7,200 - ₱7,800

As a Credentialing Specialist, you will play a crucial role in managing the credentialing and re-credentialing processes for clinicians and facilities in Applied Behavior Analysis (ABA) therapy services.

Key Responsibilities:
  • Credentialing and Re-Credentialing: Complete and maintain credentialing and re-credentialing applications for Board Certified Behavior Analysts (BCBAs), Registered Behavior Technicians (RBTs), and other ABA clinicians.
  • Application Submission: Submit applications to commercial and Medicaid payers, including CAQH, NPI, PECOS, and individual payer portals.
  • Status Tracking: Track credentialing statuses, follow up on delays, and maintain regular communication with insurance companies.
  • Documentation Management: Maintain up-to-date records of licensure, certifications, background checks, liability insurance, and other compliance documentation.
  • Start Date Coordination: Coordinate start dates with HR and scheduling teams to ensure clinicians are active before seeing clients.
  • Demographic Updates: Ensure accuracy and timely submission of demographic updates, reassignment of benefits, and provider termination notices.
  • Renewal Monitoring: Monitor credentialing expiration dates and initiate renewals in advance.
  • Payer Issues Resolution: Assist billing team with credentialing-related claim denials and payer issues.
Requirements:
  • Credentialing Expertise: Proven experience with credentialing and re-credentialing processes for healthcare professionals.
  • Communication Skills: Excellent communication and interpersonal skills to work effectively with clinicians, insurance companies, and internal stakeholders.
  • Organizational Skills: Strong organizational and time management skills to prioritize tasks and meet deadlines.
  • Attention to Detail: High attention to detail to ensure accuracy in document preparation and submission.

This is an excellent opportunity for a motivated and detail-oriented individual to join our team as a Credentialing Specialist.

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