Credentialing Specialist

Above and Beyond Therapy; Toms River (NJ); On-site; USD 34,000 - 48,000; Full time

Job summary

Above and Beyond Therapy is seeking a Credentialing Specialist to enroll employees with insurance companies and manage credentialing applications through submission and approval. The role requires healthcare credentialing experience and strong communication with insurers.

The position focuses on ensuring timely enrollment, maintaining records, and staying on top of deadlines across multiple employees and providers in a behavioral health setting.

Qualifications

• Previous credentialing experience is required.
• Experience with healthcare provider enrollment and insurance credentialing.
• Experience communicating directly with insurance companies and insurance portals.
• Strong organizational and follow-up skills.
• Excellent attention to detail.Ability to manage multiple employees and credentialing applications simultaneously.
• Strong written and verbal communication skills.
• Ability to work independently and stay on top of outstanding applications and follow-ups.
• Experience in ABA, behavioral health, mental health, or another healthcare setting is strongly preferred.
• Proficiency with Microsoft Office and computer-based credentialing systems.

Responsibilities

• Complete and submit credentialing and insurance enrollment applications for employees with various insurance companies.
• Follow up regularly with insurance companies to check the status of applications and ensure they are moving forward.
• Track applications from initial submission through final approval.
• Communicate with insurance providers regarding missing information, application issues, and additional documentation.
• Maintain accurate and up-to-date credentialing records and documentation.
• Ensure employees are properly enrolled with applicable insurance plans before providing services.
• Monitor credentialing deadlines, recredentialing requirements, and provider enrollment status.
• Identify and resolve credentialing issues or delays in a timely manner.
• Communicate with internal teams regarding credentialing status and outstanding items.
• Keep organized records of all submissions, follow-ups, approvals, and correspondence.
• Assist with recredentialing and updating provider information as needed.
• Other administrative and credentialing responsibilities as assigned.

Job description

Above and Beyond Therapy is seeking an experienced Credentialing Specialist to join our team. The Credentialing Specialist will be responsible for enrolling employees with insurance companies and ensuring that all credentialing applications are completed, submitted, and followed through to approval.

The ideal candidate has prior credentialing experience, preferably within healthcare, behavioral health, ABA, or a similar medical setting, and is comfortable communicating with insurance companies and managing multiple applications at different stages of the credentialing process.

$25 - $35 an hour

Responsibilities

• Complete and submit credentialing and insurance enrollment applications for employees with various insurance companies.
• Follow up regularly with insurance companies to check the status of applications and ensure they are moving forward.
• Track applications from initial submission through final approval.
• Communicate with insurance providers regarding missing information, application issues, and additional documentation.
• Maintain accurate and up-to-date credentialing records and documentation.
• Ensure employees are properly enrolled with applicable insurance plans before providing services.
• Monitor credentialing deadlines, recredentialing requirements, and provider enrollment status.
• Identify and resolve credentialing issues or delays in a timely manner.
• Communicate with internal teams regarding credentialing status and outstanding items.
• Keep organized records of all submissions, follow-ups, approvals, and correspondence.
• Assist with recredentialing and updating provider information as needed.
• Other administrative and credentialing responsibilities as assigned.

Qualifications

• Previous credentialing experience is required.
• Experience with healthcare provider enrollment and insurance credentialing.
• Experience communicating directly with insurance companies and insurance portals.
• Strong organizational and follow-up skills.
• Excellent attention to detail.Ability to manage multiple employees and credentialing applications simultaneously.
• Strong written and verbal communication skills.
• Ability to work independently and stay on top of outstanding applications and follow-ups.
• Experience in ABA, behavioral health, mental health, or another healthcare setting is strongly preferred.
• Proficiency with Microsoft Office and computer-based credentialing systems.

Preferred Experience

• Provider enrollment
• Insurance credentialing
• Recredentialing
• CAQH
• Medicaid and/or commercial insurance enrollment
• Healthcare or behavioral health credentialing
• Experience working with multiple insurance providers and portals

About Above and Beyond Therapy

Above and Beyond Therapy is an ABA therapy company dedicated to providing high-quality services to children and families. Our team works together to ensure that our clinical staff are properly credentialed and able to provide services to the families we serve.