Clinical Credentialing Specialist

2 days ago


San Juan, National Capital Region, Philippines beBeeCredentialing Full time ₱7,200 - ₱7,800
Clinical Credentialing Specialist

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

  • 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.

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:

  • Work-from-home opportunity.
  • Night shift schedule (EST).
  • Weekly pay.


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