ABA Credentialing & Payer Specialist

Children's Specialized ABA; Yuma (AZ); On-site; USD 52,000 - 74,000; 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 focuses on ensuring compliance with payer requirements, regulations, and company policies in a fast-paced behavioral health environment.

You will collaborate with providers, payers, and internal teams to keep credentialing records accurate and up-to-date.

Qualifications

• High school diploma or GED is required.
• 2+ years of experience in authorizations, medical insurance, billing, claims processing, credentialing, or related healthcare administration.
• Experience with insurance payers and/or healthcare provider documentation is preferred.
• ABA or Behavioral Health experience is a plus.
• Strong attention to detail and excellent organizational and time-management skills.
• Proficiency with Microsoft Office, Google Sheets, and Google Docs; ability to learn EHR systems.

Responsibilities

• Manage credentialing and re-credentialing for ABA professionals in compliance with state, federal, insurance, and organizational requirements.
• Verify and maintain credentials for BCBAs, licensed ABA professionals, and other practitioners.
• Communicate with providers and insurance payers to obtain information and resolve outstanding items.
• Review and process initial credentialing and re-credentialing applications.
• Ensure credentialing records are accurate, current, and aligned with requirements.
• Maintain approval dates, expiration dates, and other credentialing information in the EHR.
• Follow up with providers on missing documents and upcoming expirations.
• Provide status updates to providers and internal stakeholders.
• Assist providers with credentialing profiles and payer portals, troubleshooting issues.
• Stay current on Medicaid guidelines and payer regulatory changes.
• Support credentialing audits and communicate provider statuses to departments.
• Maintain organized records and track multiple credentialing items to meet deadlines.

Skills

Attention to detail

Organizational and time-management

Analytical skills

Customer service

Verbal and written communication

Multitasking

Education

High school diploma or GED

Tools

Microsoft Office

Google Sheets

Google Docs

EHR systems

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 focuses on ensuring compliance with payer requirements, regulations, and company policies in a fast-paced behavioral health environment.

You will collaborate with providers, payers, and internal teams to keep credentialing records accurate and up-to-date.