ABA Credentialing Specialist | Medical & Payer Compliance

Children's Specialized ABA; North Carolina; On-site; USD 48,000 - 65,000; Full time

Job summary

Children’s Specialized ABA is seeking a detail-oriented Credentialing Specialist to support credentialing and re-credentialing for providers across our organization. You will manage processes, verify credentials, and coordinate with providers and payers to ensure timely, compliant documentation.

Ideal candidates bring experience in medical insurance, billing, or credentialing, with strong organizational and communication skills.

Qualifications

• High school diploma or equivalent (GED) required.
• 2+ years of experience in authorizations, medical insurance, billing, claims processing, credentialing, or related healthcare administrative function.
• Experience with insurance payers or healthcare provider documentation preferred.
• ABA or Behavioral Health experience preferred.

Responsibilities

• Manage credentialing and re-credentialing for ABA professionals, ensuring regulatory and payer compliance.
• Verify and maintain credentials for BCBA and licensed ABA professionals.
• Communicate with providers and payers to obtain information and resolve items.
• Review and process initial and renewal credentialing applications.
• Maintain credentialing records with accurate dates and statuses.
• Follow up on missing documents, expirations, and deadlines.
• Assist providers with credentialing profiles and payer portals.

Skills

Attention to detail

Organizational skills

Time management

Communication skills

Multitasking

Customer service

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 Credentialing Specialist to support credentialing and re-credentialing for providers across our organization. You will manage processes, verify credentials, and coordinate with providers and payers to ensure timely, compliant documentation.

Ideal candidates bring experience in medical insurance, billing, or credentialing, with strong organizational and communication skills.