Credentialing Specialist

🔥 21 hours ago

🌵 Arizona, Illinois, +9 more states – Remote

🌵 Arizona – Remote 🌽 Illinois – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🦀 Maryland – Remote 🚗 Michigan – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote

💵 $24 - $28 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Children's Specialized ABA

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2024

🏥 Healthcare

📚 Education

Healthcare • Education

Children's Specialized ABA is a clinical provider of autism-focused services offering applied behavior analysis (ABA) therapy in both center-based and home-based settings, autism diagnostic evaluations, and complementary services such as speech and occupational therapy and family/caregiver guidance. Their multidisciplinary team includes board-certified behavior analysts, registered behavioral technicians, licensed psychologists, occupational therapists, and speech pathologists, and they partner with RWJBarnabas Health. Services are tailored by age and need (center-based for roughly 18 months–6 years; home-based up to age 12) and include early intervention, in-school and after-school support, and comprehensive parent guidance.

📋 Description

• Manage the credentialing and re-credentialing process for ABA professionals • Verify and maintain credentials for BCBAs, licensed ABA professionals, and other applicable practitioners • Communicate with providers and insurance payers to obtain required information and resolve outstanding items • Review and process initial credentialing and re-credentialing applications • Ensure credentialing records are accurate, complete, current, and compliant with payer and regulatory requirements • Maintain approval dates, expiration dates, and other credentialing information within the EHR system • Follow up with providers regarding missing documentation, upcoming expirations, renewals, and deadlines • Respond to credentialing inquiries and provide status updates to providers and internal stakeholders • Assist providers with credentialing profiles and payer portals, including troubleshooting issues and answering questions • Stay current on Medicaid guidelines, payer requirements, regulatory changes, and ABA credentialing policies • Support credentialing audits and communicate provider statuses to appropriate departments • Maintain organized records and track multiple credentialing items simultaneously to ensure deadlines are met

🎯 Requirements

• High school diploma or equivalent (GED) required • 2+ years of experience in authorizations, medical insurance, billing, claims processing, credentialing, or a related healthcare administrative function • Experience working with insurance payers and/or healthcare provider documentation preferred • ABA or Behavioral Health experience preferred • Strong attention to detail with excellent organizational and time-management skills • Strong analytical, problem-solving, and customer service skills • Ability to multitask and effectively track multiple providers, applications, deadlines, and outstanding items simultaneously • Exceptional verbal, written, and interpersonal communication skills, including professional phone and email communication • Proficiency in Microsoft Office, Google Sheets, and Google Docs, with strong overall computer skills • Ability to learn and navigate EHR systems, insurance portals, and other credentialing platforms • Visual and auditory ability to work on a computer and use a phone for extended periods of time • Ability to perform the physical requirements of the position for extended periods, including sitting, standing, bending, squatting, and kneeling

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