ABA Credentialing Specialist

ABA Credentialing Specialist

Company : Clementine ABA

Industries : ABA

Location : Remote

Employment Type : Contract, Potential Full-Time

Position Overview

Clementine ABA is seeking a highly organized and detail-oriented Credentialing Specialist to support our growing clinical team. This role is responsible for managing all aspects of provider credentialing, re-credentialing, payor enrollment, and contract management with Medicaid and various commercial insurance plans. This role will ensure that our clinical staff is properly credentialed and enrolled to deliver ABA therapy services to the families we serve. This position will start as a 6-month contract with the potential to transition to full-time

Key Responsibilities

• Submit, track, and follow up on all credentialing applications to ensure timely processing and approval with insurance payors including Medicaid and other commercial insurance plans.
• Manage the complete credentialing and enrollment process for BCBAs, RBTs, and other clinical staff.
• Maintain accurate and up-to-date credentialing files for all providers in compliance with payor requirements and regulatory standards.
• Monitor and track credentialing expiration dates and initiate re-credentialing processes proactively.
• Serve as the primary point of contact with insurance companies regarding credentialing inquiries, updates, and issues.
• Complete CAQH profile creation, updates, and attestations for providers.
• Verify provider licenses, certifications, malpractice insurance, and other required documentation.
• Maintain comprehensive knowledge of payor credentialing requirements, timelines, and procedures.
• Collaborate with billing and administrative teams to resolve credentialing-related payment issues.
• Generate reports on credentialing status and provide updates to leadership.
• Stay current on changes to credentialing requirements, insurance regulations, and industry best practices.

Qualifications

Required :

Preferred :

Equal Opportunity Employer