ABA Credentialing Specialist

7 days ago

Sorsogon, Bicol, Philippines beBeeCredentialing Full time $7,200 - $7,800
Key Job Summary

We seek a highly skilled Credentialing Coordinator to manage the credentialing and re-credentialing process for clinicians and facilities.

This role ensures seamless service delivery and reimbursement by guaranteeing all clinicians are properly credentialed and compliant. Key responsibilities include overseeing payer enrollment, tracking statuses, and maintaining records of licensure, certifications, and compliance documentation.

The ideal candidate is well-versed in payer enrollment requirements, particularly for ABA providers, and can navigate commercial and Medicaid insurance portals with ease.

Job Responsibilities
  • Manage 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.
Requirements
  • Proven experience in credentialing, 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.

Preferred Qualifications:

  • Experience working with ABA-specific software and systems.
  • Knowledge of HIPAA regulations and compliance.
  • Ability to work independently and as part of a team.
What We Offer

Our organization offers a competitive compensation package, opportunities for professional growth and development, and a dynamic work environment.

Join our team of dedicated professionals and contribute your expertise to delivering exceptional results.

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