Clinical Credentialing Specialist

15 hours ago


Batangas, Calabarzon, Philippines beBeeCredentialing Full time $7,200 - $7,800
Our organization is seeking a skilled professional to fill the role of Clinical Credentialing Specialist.The ideal candidate will have experience in credentialing and re-credentialing processes, particularly for professionals working in ABA therapy services.This position involves managing the credentialing and re-credentialing applications for BCBAs, RBTs, and other clinicians, as well as tracking credentialing statuses and maintaining regular communication with insurance companies.Maintaining up-to-date records of licensure, certifications, background checks, liability insurance, and compliance documentation is also essential.The successful candidate will ensure 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 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 accurate and timely submission of demographic updates, reassignment of benefits, and provider termination notices
  • Monitor credentialing expiration dates and initiate renewals in advance
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
Benefits:
  • Purely work-from-home opportunity
  • Night Shift (EST)
  • Weekly pay


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