Credentialing Specialist

Kyo; Austin (TX); On-site; USD 38,407 - 43,050; Full time

Job summary

Kyo is a leading provider of Applied Behavior Analysis (ABA) therapy dedicated to helping children with autism and their families. The role focuses on credentialing, recredentialing, and licensure for clinical staff, ensuring HIPAA compliance and timely data updates within CAQH/NPPES and other databases.

The position reports to the Revenue and Contracting department, requires strong collaboration across teams, and supports the onboarding process for new staff in a fast-growing organization

Qualifications

• Bachelor's Degree preferred but not required.
• Proficiency with productivity software and project management software (Microsoft Office, G Suite, Asana).
• Database management skills including querying, reporting, and document generation.
• Ability to work independently and as part of a team.
• Fast-paced, expanding organization.
• Strong knowledge of credentialing processes, accreditation and regulatory standards.

Responsibilities

• Managing credentialing, recredentialing, and licensure process for clinical staff with health insurance plans, certification boards and other agencies
• Ensuring compliance with various state, federal and payer requirements
• Pre-application intake, monitoring, application submission and follow up
• Maintaining an efficient and compliant onboarding process
• Inputting/updating provider credential databases CAQH and NPPES
• Ongoing monitoring of credentials to ensure licenses and certifications are current
• Collaborating with internal departments to exchange provider information
• Assisting with other duties in Revenue and Contracting

Skills

Credentialing

Project management

Database management

Microsoft Office

HIPAA compliance

JIRA

Communication

Independent work

Education

Bachelor's Degree preferred

Tools

CAQH

NPPES

JIRA

Job description

Kyo is a leading provider of Applied Behavior Analysis (ABA) therapy, dedicated to empowering children with autism and their families to achieve meaningful outcomes. Since 2005, we have partnered with thousands of families across 11 states, delivering effective, convenient, and child-centric ABA therapy designed around each child’s unique strengths, needs and goals. At Kyo, our mission is rooted in a commitment to making every moment count for the children and families we support.

Pay Range: $27.88 - $31.25

Candidates must reside in one of the following states: AZ, CA, CO, FL, GA, OR, TX, UT, TN, TX, WA

Primary job responsibilities may include, but are not limited to:

• Managing credentialing, recredentialing, and licensure process for clinical staff with health insurance plans, certification boards and other agencies
• Ensuring compliance with various state, federal and payer requirements
• Responsible for pre-application intake, monitoring, application submission and follow up
• Maintaining an efficient and compliant on-boarding process
• Inputing/Updating provider credential databases CAQH and NPPES
• Ongoing monitoring of clinical staff’s credentials to ensure licenses and certifications are current and active
• Working closely with internal departments to exchange provider information and follow up on inconsistencies
• Assisting with other miscellaneous duties in the Revenue and Contracting department

Qualifications:

• Bachelor's Degree preferred but not required
• Demonstrated proficiency with productivity software and project management software (Microsoft Office, G Suite, Asana)
• Database management skills including querying, reporting, and document generation
• Ability to work independently and as part of a team
• Ability to work in a fast paced, expanding organization
• Strong knowledge of the credentialing process and accreditation and regulatory standards. Ability to lead and facilitate processes through influence and collaboration
• Working knowledge of Medical Terminology
• Strong organization and verbal communication skills, attention to details required
• Ability to use independent judgment to manage and impart confidential information
• Demonstrated problem-solving skills and initiative to analyze and disseminate relevant credentialing data across internal company departments
• Ability to make priority determinations without direct supervision
• Preferred: Experience with provider credential databases CAQH, NPPES
• Preferred Experience with JIRA
• Preferred: Experience with HIPAA and compliance-sensitive environments
• Willingness and ability to provide proof of completed COVID-19 vaccination and booster (if eligible), no later than your scheduled start date. If you believe you are entitled to either a medical or religious exemption to our vaccination requirement, please notify your Kyo interviewer immediately so that your situation can be evaluated by Human Resources

Physical Requirements:

• Must be able to sit and use a computer for extended periods of time
• Exhibit manual dexterity to regularly use and enter data into a computer/tablet/phone
• Ability to read and interpret documents in the English language such as employee handbooks, training materials and procedure manuals
• No or very limited exposure to physical risk
• No or very limited physical effort required
• Ability to perform data entry, operate standard office equipment e.g. copiers, fax
• Willingness and ability to provide proof of completed COVID-19 vaccination and booster (if eligible), no later than your scheduled start date. (If you believe you are entitled to either a medical or religious exemption to our vaccination requirement, please notify your Kyo recruiter immediately so that your request may be reviewed by HR.)

Kyo is dedicated to protecting vulnerable populations, including youth. As a result, we conduct comprehensive background checks and fingerprint screenings for all potential employees. These screenings will reveal your entire criminal record, including convictions that have been expunged, sealed, dismissed, or otherwise modified, regardless of when the offense occurred. Please note: Having a criminal conviction will not automatically disqualify you from employment. Each case is evaluated individually, taking into account the nature of the offense, its relevance to the role, the time elapsed, and the surrounding circumstances.