
Certified Professional for Healthcare Documentation Management
7 days ago
We are seeking a highly skilled and experienced Credentialing Specialist to manage the credentialing and re-credentialing processes for our clinicians and facilities.
- 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
This role requires strong organizational and time management skills, as well as excellent written and verbal communication skills.
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
- Purely work-from-home arrangement
- Night Shift (EST)
- Weekly pay
- Mid-Senior level
- Full-time
- Health Care Provider
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