Credentialing Specialist

childrens-aba; North Carolina; Remote; USD 35,000 - 50,000; Full time

Job summary

A leading company focused on Autism Spectrum Disorder seeks a Credentialing Specialist to manage the credentialing workflow for ABA providers. This remote role requires meticulous attention to detail, strong communication skills, and a passion for customer service. Candidates will gather, verify, and maintain provider data, ensuring compliance with payor and regulatory requirements.

Qualifications

• Entry-level welcome; background in customer service, call centers, or office administration preferred.
• Basic proficiency in Microsoft Office required.

Responsibilities

• Own the credentialing workflow for new and existing ABA practitioners.
• Verify licensure and certifications for BCBAs, RBTs, and other clinicians.
• Serve as the liaison between providers, insurance payors, and internal departments.

Skills

Attention to detail

Organizational skills

Time management

Verbal communication

Written communication

Customer service

Multitasking

Education

High school diploma or GED

Tools

Microsoft Office

Job description

About Children's Specialized ABA

Children’s Specialized ABA is designed to address the comprehensive needs of children, teens, and young adults diagnosed with Autism Spectrum Disorder (ASD). By leveraging the expertise of the Children’s Specialized Hospital Autism Center of Excellence, the program aims to expand access to innovative and compassionate care, empowering children diagnosed with autism to thrive. Children’s Specialized ABA embraces a holistic approach, recognizing the interconnectedness of physical, emotional, and social well-being, ensuring every aspect of a patient’s life is considered in their therapeutic journey.

Our integrated care model brings ABA therapy services augmented by complementary therapies, such as speech and language, occupational, and behavioral health services, ensuring a comprehensive, whole-child approach that supports a wide range of needs, from verbal to behavioral and social skills.

The Values that set Children's Specialized ABA apart

• Inclusivity: We celebrate the diversity within the Autism spectrum and are committed to creating an inclusive environment that respects and values each person’s individual strengths and differences.
• Innovation: We foster a culture of creativity and collaboration, exploring new ideas to develop personalized solutions that enhance quality of life for all children with Autism.
• Connection: We actively engage with the health systems and broader community to coordinate services and care for people with Autism.
• Quality and Safety: We invest in research and training to provide cutting-edge, effective, safe, and personalized services tailored to the unique needs of those we serve.

Summary

The Credentialing Specialist supports the full life-cycle credentialing of ABA providers across multiple states and insurance plans. You will gather and verify licensure and demographic data, prepare and track applications, maintain accurate records, and keep internal stakeholders informed—all while ensuring compliance with payor, state, and federal requirements.

This role is 100% remote. Candidates must live in one of the following states: AZ, FL, GA, IL, IN, MD, MI, MO, NC, NJ, OH, PA, TN, TX, VA

Responsibilities

• Own the credentialing workflow for new and existing ABA practitioners—collect documentation, complete applications, and monitor progress through approval.
• Verify licensure and certifications for BCBAs, RBTs, and other clinicians; track expirations and initiate timely re-credentialing.
• Serve as the liaison between providers, insurance payors, and internal departments; deliver clear updates on status and next steps.
• Maintain pristine records in our EHR, payor portals, and internal tracking tools to guarantee data accuracy and audit readiness.
• Stay current on Medicaid guidelines, payor policies, and regulatory changes; recommend process improvements to keep us ahead of the curve.
• Assist with audits and documentation requests related to credentialing compliance.

Qualifications and Requirements

• Education: High school diploma or GED.
• Experience: Entry-level welcome—background in customer service, call centers, or office administration is preferred.
• Skills & Traits:
• Meticulous attention to detail with strong organizational and time-management abilities.
• Confident multitasker who thrives in a fast-paced, ever-changing environment.
• Excellent verbal and written communication; comfortable handling phone and email inquiries.
• Basic proficiency in Microsoft Office (especially Outlook and Excel) and the ability to learn multiple web portals quickly.
• Positive, solution-oriented mindset and a passion for great customer service.
• Must successfully pass a background check upon hire.
• This role involves prolonged periods of sitting and computer work.