Credentialing Specialist
Location: Remote
Job Type: Full-time

About the Role
We are seeking a Credentialing Specialist to coordinate and perform a variety of operational duties required for provider credentialing and enrollment. This role will interact extensively with BCBAs, Care Coordinators, Health Plans, recruitment and clinical teams, and leadership. The ideal candidate will contribute meaningfully to the organization’s mission by facilitating provider enrollment and maximizing reimbursement for services rendered.

What You’ll Do

Collaborate with BCBAs to maintain CAQH profiles for clean credentialing
Maintain BCBA documentation, including onboarding documents required for credentialing
Enroll providers with commercial and government payors; revalidate providers with relevant health plans
Accurately complete and submit enrollment applications and related documents to health plans
Audit payor directories to ensure current and accurate provider information
Handle payor calls to resolve contracting and credentialing issues
Ensure compliance with regulatory requirements from commercial health plans and state agencies
Prepare commercial, Medicaid, and third-party application forms for new provider credentialing and enrollment
Manage reports and provider accounts for re-credentialing, re-validation, and expirables
Attend health plan trainings to keep internal teams informed of insurance process updates

About You

Eager to join a mission-driven organization with a focus on transforming ABA service delivery
Strong and clear communicator who builds trust and team alignment
Detail-oriented and committed to delivering high-quality work
Proactive problem-solver with a sense of urgency
Curious and motivated learner who embraces new challenges
Capable of managing multiple tasks and shifting priorities efficiently

Requirements

Minimum 3 years of relevant experience in ABA credentialing preferred
At least 1 year of experience working in ABA settings is required
Minimum 1 year of credentialing experience is required

Credentialing Specialist (39262014079)