Certified Healthcare Professional

2 days ago

Paranaque City, Calabarzon, Philippines beBeeCredentialing Full time $7,200 - $7,800
Credentialing Specialist Role

We are seeking a highly skilled and detail-oriented Credentialing Specialist to manage the credentialing and re-credentialing processes for our clinicians and facilities.


  • Develop and maintain accurate and up-to-date credentialing applications for licensed professionals, including BCBAs, RBTs, and other ABA clinicians.
  • Submit applications to commercial and Medicaid payers through various portals, ensuring timely and efficient processing.
  • Monitor credentialing statuses, follow up on delays, and maintain regular communication with insurance companies to ensure seamless processing.
  • Maintain comprehensive records of licensure, certifications, background checks, liability insurance, and other compliance documentation.
  • Coordinate start dates with HR and scheduling teams to guarantee a smooth transition for new clinicians.
  • Ensure accuracy and timely submission of demographic updates, reassignment of benefits, and provider termination notices.
  • Proactively monitor credentialing expiration dates and initiate renewals in advance to prevent any lapses.
  • Collaborate with the billing team to resolve credentialing-related claim denials and payer issues.

The ideal candidate will possess extensive experience in credentialing processes and insurance requirements, particularly for ABA providers. They must be proficient in EMR systems like CentralReach, Rethink, or Catalyst and exhibit exceptional organizational and time management skills.

This is a remote work opportunity offering flexible working hours and a competitive compensation package.

Requirements:
  • Significant experience in credentialing processes, preferably in ABA or behavioral health.
  • Thorough knowledge of credentialing procedures and insurance regulations.
  • Familiarity with BACB and state licensing requirements for ABA professionals.
  • Excellent analytical and problem-solving skills.
  • Strong written and verbal communication skills.
  • Proficiency in EMR systems.
  • Ability to maintain confidentiality and handle sensitive information with precision.

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