ABA Credentialing Professional

2 days ago

General Santos, Soccsksargen, Philippines beBeeCredentialing Full time $7,200 - $7,800
Credentialing Specialist Position

We are seeking an experienced Credentialing Specialist to oversee the credentialing and re-credentialing processes for our clinicians and facilities. The ideal candidate will have a strong background in ABA therapy services and be well-versed in payer enrollment requirements, particularly for ABA providers.

This role ensures that all clinicians are properly credentialed and compliant, allowing uninterrupted service delivery and reimbursement.

Key Responsibilities:
  • 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
  • Stay updated with payer policy changes and credentialing guidelines, especially those impacting ABA services
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
  • Knowledge of ABA-specific billing and compliance processes
Benefits:
  • Remote work opportunity
  • Night shift schedule (EST)
  • Weekly pay

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