ABA Credentialing & Payer Compliance Specialist

Childrens Aba; New Jersey; On-site; USD 42,000 - 62,000; Full time

Job summary

Children’s Specialized ABA is seeking a detail-oriented ABA Credentialing Specialist to support credentialing and re-credentialing of providers across our organization. The role ensures compliance with payer requirements, state and federal regulations, and company policies while coordinating with providers, payers, and internal teams to maintain accurate documentation.

The ideal candidate will manage provider credentials, track expirations, and resolve items promptly, ensuring smooth payer

Qualifications

• 2+ years of experience in authorizations, medical insurance, billing, claims processing, credentialing, or related healthcare admin functions.
• Experience working with insurance payers and/or healthcare provider documentation preferred.
• ABA or Behavioral Health experience preferred.
• Strong verbal, written, and interpersonal communication skills.

Responsibilities

• Manage credentialing and re-credentialing for ABA professionals, ensuring compliance with state, federal, payer and organizational requirements.
• Verify and maintain credentials for BCBAs, licensed ABA professionals, and other applicable practitioners.
• Communicate with providers and payers throughout the credentialing process to obtain required information and resolve items.
• Review and process documentation for initial credentialing and re-credentialing applications.
• Maintain credentialing records: approvals, expirations, and other data in the EHR system.
• Follow up with providers on missing docs, upcoming expirations, renewals, and deadlines.
• Respond to credentialing inquiries with timely status updates to providers and internal stakeholders.
• Assist providers with credentialing profiles and payer portals; troubleshoot issues and questions.
• Stay current on Medicaid guidelines, payer requirements, and regulatory changes.
• Support credentialing audits and communicate statuses to departments.
• Maintain organized records and track multiple credentialing items to meet deadlines.

Skills

Credentialing

Attention to detail

Time management

Education

High school diploma

Tools

Microsoft Office

Google Sheets

Google Docs

Job description

Children’s Specialized ABA is seeking a detail-oriented ABA Credentialing Specialist to support credentialing and re-credentialing of providers across our organization. The role ensures compliance with payer requirements, state and federal regulations, and company policies while coordinating with providers, payers, and internal teams to maintain accurate documentation.

The ideal candidate will manage provider credentials, track expirations, and resolve items promptly, ensuring smooth payer