ABA Credentialing & Compliance Specialist

Children's Specialized ABA; Maryland; On-site; USD 52,000 - 75,000; Full time

Job summary

Children’s Specialized ABA is seeking a detail-oriented Credentialing Specialist to manage credentialing and re-credentialing for ABA professionals, ensuring compliance with payer requirements and regulatory standards.

The role involves interacting with providers, payers, and internal teams, maintaining accurate credentialing data, and staying current with Medicaid guidelines and credentialing timelines.

Qualifications

• High school diploma or GED required.
• 2+ years in authorizations, medical insurance, billing, or credentialing.
• Experience with insurance payers or healthcare documentation preferred.

Responsibilities

• Manage credentialing and re-credentialing for ABA professionals.
• Verify credentials for BCBAs and licensed professionals.
• Communicate with providers and payers to obtain information.
• Review and process initial and renewal credentialing applications.
• Maintain credentialing records and expirations in the EHR.
• Follow up on missing documents and upcoming expirations.

Skills

Attention to detail

Time-management

Communication skills

Organizational skills

Education

High school diploma

Tools

Microsoft Office

Google Sheets

Google Docs

EHR systems

Insurance portals

Job description

Children’s Specialized ABA is seeking a detail-oriented Credentialing Specialist to manage credentialing and re-credentialing for ABA professionals, ensuring compliance with payer requirements and regulatory standards.

The role involves interacting with providers, payers, and internal teams, maintaining accurate credentialing data, and staying current with Medicaid guidelines and credentialing timelines.