Hybrid Credentialing & Compliance Specialist

Golden Steps ABA; Englewood Cliffs (NJ); Hybrid; USD 48,000 - 75,000; Full time

Benefits offered by this job

Tuition discounts

CME libraries

RBT training

University discounts

Paid training

Job summary

Golden Steps ABA is seeking a Credentialing Specialist to manage provider credentialing across states and maintain CAQH accounts. The role supports therapists by processing applications for commercial payers, Medicare, and Medicaid, and by coordinating with billing and leadership in a hybrid, employee-centric environment.

Responsibilities include acquiring contracts, updating provider files, and ensuring accurate logins while navigating state regulations and payer requirements to support

Responsibilities

• Acquire contracts for all insurances partnering within the applicable states.
• Assess the needs of each state to comply with state regulations.
• Create individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.
• Maintain internal provider framework to ensure all information is accurate and logins are available.
• Update and maintain CAQH accounts.
• Complete revalidation requests issued by government payers.
• Process credentialing applications to add therapists to commercial payers, Medicare, and Medicaid.
• Creating NPI's when necessary for individual therapists.
• Process re-credentialing applications for commercial payers.
• Working closely with the billing department to negotiate contract rates.
• Meet deadlines and communicate updates regularly with leadership and respective parties.
• Other duties as assigned.

Job description

Golden Steps ABA is seeking a Credentialing Specialist to manage provider credentialing across states and maintain CAQH accounts. The role supports therapists by processing applications for commercial payers, Medicare, and Medicaid, and by coordinating with billing and leadership in a hybrid, employee-centric environment.

Responsibilities include acquiring contracts, updating provider files, and ensuring accurate logins while navigating state regulations and payer requirements to support