Certified Credential Specialist

1 day ago

Bacoor, Calabarzon, Philippines beBeeCredentialing Full time $7,200 - $7,800

This is a detail-oriented and experienced position that manages the credentialing and re-credentialing processes for clinicians and facilities.

Job Description:

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

Main Responsibilities:

  • Credentialing and Re-Credentialing: Complete and maintain credentialing and re-credentialing applications for BCBAs, RBTs, and other ABA clinicians.
  • Payer Submissions: Submit applications to commercial and Medicaid payers, including CAQH, NPI, PECOS, and individual payer portals.
  • Credentialing Status Tracking: Track credentialing statuses, follow up on delays, and maintain regular communication with insurance companies.
  • Record Maintenance: 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.
  • Credentialing Expiration Monitoring: Monitor credentialing expiration dates and initiate renewals in advance.
  • Claim Denials Assistance: Assist billing team with credentialing-related claim denials and payer issues.
  • Payer Policy Updates: Stay updated with payer policy changes and credentialing guidelines, especially those impacting ABA services.
Requirements:
  • Credentialing Experience: Credentialing experience, preferably in ABA or behavioral health.
  • Knowledge of Credentialing Processes: Strong knowledge of credentialing processes and insurance requirements (Medicaid, private payers, CAQH, etc.).
  • Familiarity with Licensing Requirements: Familiarity with BACB and state licensing requirements for ABA professionals.
  • Organizational Skills: Excellent organizational and time management skills.
  • Communication Skills: Strong written and verbal communication skills.
  • EMR Proficiency: Proficiency with EMR systems like CentralReach, Rethink, or Catalyst.
  • Confidentiality: Ability to manage sensitive information with a high level of confidentiality and accuracy.
  • ABA-Specific Knowledge: Knowledge of ABA-specific billing and compliance processes.
Benefits:

We offer a purely work-from-home opportunity.

Seniority Level:

Mid-Senior level.

Employment Type:

Full-time.

Job Function:

Health Care Provider.

Industry:

Technology, Information and Internet.

  • Credentialing Expert

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeCredentialing Full time $50,000 - $75,000

    ClinicMind: Certified Credentialing SpecialistWe are seeking a skilled professional to fill this credentialing position. As a Credentialing Specialist, you will be responsible for collecting and maintaining accurate client information using online databases.Responsibilities:Credentialing Work: Assist providers with payer forms, respond to inquiries, and...

  • Credentialing Specialist

    2 days ago

    Bacoor, Calabarzon, Philippines RemoteVA Full time

    OverviewWe are seeking a detail-oriented and experienced Credentialing Specialist with a strong background in ABA therapy services to manage the credentialing and re-credentialing processes for our clinicians and facilities. The ideal candidate is well-versed in payer enrollment requirements, particularly for ABA providers, and can navigate commercial and...

  • Healthcare Credentialing Professional

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeCredentialing Full time $60,000 - $80,000

    Are you a skilled professional seeking a challenging role in healthcare credentialing? We are looking for an experienced Credentialing Specialist to join our team. In this position, you will be responsible for overseeing the credentialing and enrollment processes for healthcare providers practicing in Maryland. Your work will be essential in ensuring...

  • Healthcare Credentialing Specialist

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeCredentialing Full time ₱30,000 - ₱45,000

    Job Title: Credentialing CoordinatorAs a Credentialing Coordinator, you will be responsible for providing comprehensive support for all aspects of the credentialing and re-credentialing process. This includes managing applications, conducting primary source verification, and maintaining the credentialing database with accuracy and attention to detail.Provide...

  • Certified Healthcare Professional

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeCredentialing Full time ₱360,000 - ₱540,000

    Job OverviewWe are seeking a highly organized and detail-oriented Credentialing Specialist to empower autism care providers.Main Responsibilities:Comprehensive Support: Provide thorough support for the credentialing and re-credentialing process.Regulatory Compliance: Ensure adherence to federal, state, and local regulations, as well as accreditation...

  • ABA Credentialing Specialist

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeCredentialing Full time $7,200 - $7,800

    Job OverviewWe are seeking a detail-oriented and experienced professional to manage the credentialing and re-credentialing processes for our clinicians and facilities. The ideal candidate is well-versed in payer enrollment requirements, particularly for ABA providers.This role ensures that all clinicians are properly credentialed and compliant, allowing...

  • Provider Credentialing Specialist

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeCredentialing Full time $12,000 - $15,600

    About the PositionWe are seeking a detail-driven professional to ensure accuracy, compliance, and timeliness across provider credentialing workflows in a fast-paced healthcare environment.Key ResponsibilitiesManage the full provider credentialing lifecycle from document collection to final approvalsVerify licenses, certifications, education, and work history...

  • Certified Medical Billing and Coding Expert

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeMedical Full time ₱350,000 - ₱500,000

    Job Title: Medical Coding SpecialistWe are seeking a skilled Certified Medical Biller and Coder to excel in accurate and timely submission of medical claims, optimizing revenue cycles while maintaining compliance with regulatory standards.Key Responsibilities:Analyze and abstract medical information from patient records for physician/NP visits and home...

  • Educational Support Specialist

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeCredential Full time ₱50,000 - ₱70,000

    Job Title: Educational Support SpecialistWe are seeking an experienced and detail-oriented Educational Support Specialist to join our team. This role requires strong organizational skills, a keen eye for detail, and excellent communication abilities.The ideal candidate will have experience in managing onboarding workflows, verifying credentials, and...

  • Healthcare Claims Specialist

    1 day ago

    Bacoor, Calabarzon, Philippines beBeeClaims Full time ₱416,000 - ₱524,800

    Job Title: Healthcare Claims SpecialistJob DescriptionThe ideal candidate will possess strong attention to detail, a liking for systems and processes, and excellent written and oral communication skills.We are seeking an organized and efficient individual to verify insurance coverage for new and existing patients. The selected candidate will be responsible...