Credentialing Specialist

This is a fully remote position, open to applicants in Arizona, +10 more states.

📋 Description

• Oversee the credentialing and re-credentialing processes for ABA professionals.

• Verify and uphold credentials for BCBAs, licensed ABA professionals, and other relevant practitioners.

• Liaise with providers and insurance payers to gather necessary information and resolve any outstanding issues.

• Evaluate and process initial credentialing and re-credentialing applications.

• Ensure that credentialing records are accurate, complete, up-to-date, and compliant with payer and regulatory standards.

• Maintain approval dates, expiration dates, and other credentialing details within the EHR system.

• Follow up with providers regarding missing documentation, upcoming expirations, renewals, and deadlines.

• Address credentialing inquiries and provide status updates to both providers and internal stakeholders.

• Assist providers with their credentialing profiles and payer portals, including troubleshooting issues and answering queries.

• Remain informed on Medicaid guidelines, payer requirements, regulatory changes, and ABA credentialing policies.

• Support credentialing audits and communicate provider statuses to the relevant departments.

• Keep organized records and manage multiple credentialing tasks simultaneously to ensure deadlines are adhered to.

⛳️ Requirements

• High school diploma or equivalent (GED) is mandatory.

• A minimum of 2 years of experience in authorizations, medical insurance, billing, claims processing, credentialing, or a related healthcare administrative role.

• Experience collaborating with insurance payers and/or managing healthcare provider documentation is preferred.

• Background in ABA or Behavioral Health is advantageous.

• Meticulous attention to detail coupled with exceptional organizational and time-management abilities.

• Strong analytical, problem-solving, and customer service competencies.

• Capability to multitask and efficiently monitor multiple providers, applications, deadlines, and outstanding issues concurrently.

• Outstanding verbal, written, and interpersonal communication skills, including professionalism in phone and email correspondence.

• Proficiency in Microsoft Office, Google Sheets, and Google Docs, along with strong overall computer skills.

• Ability to learn and navigate EHR systems, insurance portals, and other credentialing platforms.

• Visual and auditory capacity to work on a computer and use a phone for extended durations.

• Physical ability to fulfill the job requirements for extended periods, including sitting, standing, bending, squatting, and kneeling.

🏝️ Benefits

• Competitive salary and performance-based bonuses.

• Comprehensive health, dental, and vision insurance.

• Opportunities for professional development and career advancement.

• Flexible work schedules and remote work options.

• Supportive and inclusive workplace culture.