Credentialing Specialist (ABA / Insurance Credentialing VA)

Genius Agency AI; Virginia; On-site; USD 50,000 - 70,000; Full time

Job summary

A healthcare service provider is seeking an experienced Credentialing Specialist to support ABA therapy services for children with autism. The ideal candidate will have robust experience in US medical credentialing, particularly credentialing Board Certified Behavior Analysts and therapists with various insurance payers. Responsibilities include managing credentialing applications and ensuring compliance with regulatory requirements. This role demands excellent documentation and communication skills, emphasizing independence and thorough knowledge of insurance processes.

Qualifications

• At least 2 years experience in US medical credentialing.
• Experience credentialing Board Certified Behavior Analysts (BCBA) or therapists.
• Strong knowledge of US insurance credentialing process.

Responsibilities

• Process provider credentialing applications.
• Manage CAQH provider profiles and updates.
• Credential providers with insurance networks.

Skills

Experience in US medical credentialing

Excellent documentation skills

Strong communication skills

Ability to work independently

Job description

Global Pacific Support is seeking an experienced Credentialing Specialist to support Ready Set And Go ABA, a provider of compassionate and evidence-based Applied Behavior Analysis (ABA) Therapy services for children with autism. The ideal candidate has experience credentialing behavior analysts and therapists with US insurance payers.

Responsibilities

• Process provider credentialing applications
• Manage CAQH provider profiles and updates
• Credential providers with insurance networks such as:
  • Aetna
  • Cigna
  • UnitedHealthcare
  • Blue Cross Blue Shield
  • Tricare
• Maintain credentialing documents and licenses
• Track credentialing status and payer approvalsFollow up with insurance companies regarding applications
• Ensure compliance with payer and regulatory requirements

Requirements

• At least 2 years experience in US medical credentialing
• Experience credentialing Board Certified Behavior Analysts (BCBA), therapists, or healthcare providers
• Experience with CAQH, NPI registration, and payer enrollment
• Strong knowledge of US insurance credentialing process
• Excellent documentation and communication skills
• Ability to work independently

Preferred

• ABA therapy credentialing experience
• Familiarity with CPT codes and ABA billing
• Experience working with US healthcare practices