Certification Coordinator

1 week ago

Pagadian, Zamboanga Peninsula, Philippines beBeeCredentialing Full time ₱7,200 - ₱7,800
Credentialing Specialist

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

The ideal candidate will have a strong background in ABA therapy services, be well-versed in payer enrollment requirements, particularly for ABA providers, and possess the ability to 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.

Key Responsibilities:
  • Manage and maintain credentialing and re-credentialing applications for BCBAs, RBTs, and other ABA clinicians
  • Submit applications to commercial and Medicaid payers through various channels including CAQH, NPI, PECOS, and individual payer portals
  • Track credentialing statuses, follow up on delays, and maintain regular communication with insurance companies to ensure seamless operations
  • Maintain up-to-date records of licensure, certifications, background checks, liability insurance, and other compliance documentation to prevent any discrepancies
  • Coordinate start dates with HR and scheduling teams to guarantee clinicians are active before seeing clients
  • Ensure accuracy and timely submission of demographic updates, reassignment of benefits, and provider termination notices to avoid any issues
  • Monitor credentialing expiration dates and initiate renewals in advance to maintain continuous service delivery
  • Collaborate with the billing team to address credentialing-related claim denials and payer issues to optimize revenue cycle management

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