Credentialing Specialist

Golden Steps ABA, LLC; Englewood Cliffs, Northern (NJ, KY); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Competitive compensation

Hybrid work schedule

Medical, dental, and vision insurance

Paid time off

401(k) plan with company match

Professional development

Tuition discounts

Team events

Job summary

Golden Steps ABA is seeking a Credentialing Specialist to manage provider credentialing and payer enrollment across multiple states. You will help ensure clinicians can begin services promptly by maintaining accurate CAQH, NPI, and payer records while meeting deadlines.

The ideal candidate has healthcare credentialing experience, familiarity with Medicaid and commercial payers, and strong attention to detail in a fast-paced environment. Hybrid work arrangement applies.

Qualifications

• Two years of healthcare credentialing or payer enrollment experience.
• Experience with CAQH and the NPI Registry.
• Experience with Medicaid and commercial payers.
• Excellent attention to detail and ability to meet deadlines.
• Proficiency with Microsoft Office or Google Workspace.

Responsibilities

• Complete credentialing and payer enrollment applications for providers and entities.
• Enroll providers with Medicaid and commercial plans per state requirements.
• Maintain CAQH profiles and update NPI records as needed.
• Track submissions and resolve missing information with payers.
• Maintain provider files and protect confidential information.
• Collaborate with Billing and Operations to activate providers.

Skills

Credentialing

CAQH

NPI Registry

Payer enrollment

Medicaid enrollment

Attention to detail

High-volume workload

Office suite

Independent / collaborative

Education

High school diploma

Job description

Overview

Location: Englewood Cliffs, New Jersey 07632Work Arrangement: Hybrid - 3 Days in Office, 2 Days Remote Golden Steps ABA is seeking an organized and detail-oriented Credentialing Specialist to manage provider credentialing and payer enrollment across our growing, multi-state organization. This role helps ensure our clinicians are credentialed accurately and efficiently so they can begin providing services to children and families without unnecessary delays.

The ideal candidate has experience with healthcare credentialing, Medicaid and commercial payer enrollment, CAQH, and NPI registration. You must be comfortable managing multiple applications, deadlines, and payer requirements in a fast-paced environment.

Responsibilities

What You’ll Do

• Complete initial credentialing, recredentialing, and payer enrollment applications for individual providers and applicable entities.
• Enroll providers with Medicaid and commercial insurance plans based on payer and state requirements.
• Research and maintain current knowledge of credentialing and enrollment requirements across assigned states.
• Create and maintain accurate provider files, including licenses, certifications, education, employment history, attestations, and other required documentation.
• Maintain CAQH profiles, including documentation updates and re-attestations.
• Create and update National Provider Identifier (NPI) records when needed.
• Complete payer revalidation and recredentialing requests within required deadlines.
• Track applications from submission through approval and follow up with payers to address delays or missing information.
• Maintain accurate records of payer applications, login credentials, approval dates, effective dates, and renewal requirements.
• Identify missing, expired, or inconsistent provider information and coordinate timely resolution.
• Communicate credentialing status, delays, risks, and next steps to leadership and internal partners.
• Collaborate with Billing and Operations to support provider activation and accurate payer participation.
• Assist with payer contracting documentation and credentialing audits as needed.
• Protect confidential provider and organizational information.

Qualifications

What You’ll Bring

Required Qualifications

• High school diploma or equivalent.
• At least two years of healthcare credentialing, provider enrollment, or payer enrollment experience.
• Hands-on experience with CAQH and the NPI Registry.
• Experience submitting applications to Medicaid and commercial insurance payers.
• Strong attention to detail and commitment to maintaining complete, accurate records.
• Ability to manage a high-volume workload with competing priorities and firm deadlines.
• Strong written and verbal communication skills.
• Effective problem-solving, follow-up, and organizational skills.
• Proficiency with Microsoft Office or Google Workspace, including spreadsheets.
• Ability to work independently while collaborating effectively across departments.

Preferred Qualifications

• Experience in behavioral health, applied behavior analysis, pediatric therapy, or a multi-site healthcare organization.
• Experience with multi-state Medicaid enrollment and state-specific credentialing requirements.
• Familiarity with payer rosters, revalidations, contracting documentation, or credentialing audits.

What Success Looks Like

• Credentialing applications are complete, accurate, and submitted on time.
• Provider records remain current and audit-ready.
• Renewal and recredentialing deadlines are managed proactively.
• Delays and barriers are identified, escalated, and resolved quickly.Providers move through the enrollment process as efficiently as possible.

Benefits

Why Join Golden Steps ABA?

Golden Steps ABA provides compassionate, high-quality applied behavior analysis services to children and families across multiple states. Our employees are united by a commitment to clinical excellence, meaningful outcomes, and creating an environment where both our clients and team members can thrive.

Eligible employees have access to:

• Competitive compensation
• A hybrid work schedule
• Medical, dental, and vision insurance
• Paid time off, sick leave, and company holidays
• A 401(k) plan with company match
• Professional development and advancement opportunities
• Tuition discounts through participating university partners
• Team events and employee engagement activities

Golden Steps ABA provides equal employment opportunities without regard to race, color, religion, creed, age, marital status, sex, sexual orientation, gender identity or expression, citizenship status, national origin, ethnicity, military or veteran status, disability, or any other characteristic protected by applicable law.