Credentialing Specialist

📋 Description

• Manage end-to-end credentialing and re-credentialing for BCBAs and RBTs across all payors—initial enrollment, recredentialing, updates, and status maintenance.
• Own the submission lifecycle: compile docs, portal submission, follow-up, resolution, with auditable trail.
• Ensure credentials (BACB certification, BLS, Safety Care, NPI, CAQH, diplomas, licenses) are current and audit-ready.
• Coordinate with HR, Training, Clinical, Scheduling to prevent start-date delays.
• Help clinicians navigate credentialing with resources and support.
• Oversee BACB RBT Requirements Coordinator process and BACB portal maintenance, audits.

🎯 Requirements

• Prior credentialing or provider enrollment experience in healthcare; ABA credentialing preferred.
• Hands-on CAQH, NPI, and payor portal experience; audit-ready provider files.
• Ability to build or improve credentialing processes (SOPs, tracking tools, checklists).
• Comfort analyzing credentialing data to surface patterns and delays.
• Familiarity with Medicaid MCOs and/or TRICARE a plus.
• CentralReach experience preferred; not required.
• Bachelor’s degree or equivalent professional experience.