ABA Credentialing Specialist — Payer Compliance

Childrens Aba; Kearny (NJ); Hybrid; USD 48,000 - 64,000; Full time

Job summary

Children's Specialized ABA is seeking a detail-oriented ABA Credentialing Specialist to support credentialing across the organization. You will manage credentialing/ re-credentialing, verify BCBA and licensed provider credentials, and liaise with providers and payers to ensure timely and accurate documentation.

The role requires 2+ years in authorizations, medical insurance, or credentialing, with strong organizational and communication skills and proficiency in EHR systems and payer portals.

Qualifications

• 2+ years of experience in authorizations, medical insurance, billing, claims processing, credentialing, or related healthcare admin.
• Experience with insurance payers and/or healthcare provider documentation preferred.
• ABA or Behavioral Health experience preferred.
• Strong attention to detail and excellent organizational/time-management skills.

Responsibilities

• Manage credentialing and re-credentialing for ABA professionals, ensuring compliance with requirements.
• Verify credentials for BCBAs, licensed ABA professionals, and other practitioners.
• Communicate with providers and payers to obtain information and resolve items.
• Review and process initial credentialing and re-credentialing applications.
• Maintain credentialing records, approvals, expirations, and dates in the EHR.
• Follow up on missing documentation, renewals, and deadlines.
• Provide timely status updates to providers and internal stakeholders.
• Assist with credentialing profiles and payer portals, troubleshooting as needed.
• Stay current on Medicaid guidelines, payer requirements, and regulatory changes.
• Support credentialing audits and communicate provider statuses to departments.
• Maintain organized records and track multiple items to meet deadlines.

Skills

Attention to detail

Organizational skills

Time management

Analytical thinking

Customer service

Verbal and written communication

Multitasking

Education

High school diploma or GED

Tools

Microsoft Office

Google Sheets

Google Docs

EHR systems

Payer portals

Job description

Children's Specialized ABA is seeking a detail-oriented ABA Credentialing Specialist to support credentialing across the organization. You will manage credentialing/ re-credentialing, verify BCBA and licensed provider credentials, and liaise with providers and payers to ensure timely and accurate documentation.

The role requires 2+ years in authorizations, medical insurance, or credentialing, with strong organizational and communication skills and proficiency in EHR systems and payer portals.