Credentialing Specialist (ABA / Insurance Credentialing VA)

Global Pacific Support; Philippines; Remote; PHP 334,800 - 446,400; Full time

Job summary

A healthcare services company is seeking an experienced Credentialing Specialist in the Philippines to manage provider credentialing applications, especially for ABA therapy. Ideal candidates will have at least 2 years of experience with US medical credentialing and strong skills in documentation and communication. This role requires maintaining compliance with payer requirements and managing relationships with insurance networks such as Aetna and UnitedHealthcare.

Qualifications

• At least 2 years experience in US medical credentialing.
• Experience credentialing Board Certified Behavior Analysts (BCBA) or healthcare providers.
• Strong knowledge of US insurance credentialing processes.

Responsibilities

• Process provider credentialing applications.
• Manage CAQH provider profiles and updates.
• Credential providers with insurance networks.

Skills

US medical credentialing

Communication skills

Independent working

Job description

Global Pacific Support is seeking an experienced Credentialing Specialist to support Ready Set And Go ABA, a provider of compassionate and evidence-based Applied Behavior Analysis (ABA) Therapy services for children with autism.

The ideal candidate has experience credentialing behavior analysts and therapists with US insurance payers.

Responsibilities

• Process provider credentialing applications
• Manage CAQH provider profiles and updates
• Credential providers with insurance networks such as:
  • Aetna
  • Cigna
  • UnitedHealthcare
  • Blue Cross Blue Shield
  • Tricare
• Maintain credentialing documents and licenses
• Track credentialing status and payer approvals
• Follow up with insurance companies regarding applications
• Ensure compliance with payer and regulatory requirements

Requirements

• At least 2 years experience in US medical credentialing
• Experience credentialing Board Certified Behavior Analysts (BCBA), therapists, or healthcare providers
• Experience with CAQH, NPI registration, and payer enrollment
• Strong knowledge of US insurance credentialing process
• Excellent documentation and communication skills
• Ability to work independently

Preferred

• ABA therapy credentialing experience
• Familiarity with CPT codes and ABA billing
• Experience working with US healthcare practices