Credentialing Specialist - ABA (Applied Behavior Analysis)

The Credentialing Specialist will complete and maintain credentialing and re-credentialing applications for BCBAs, RBTs, and other ABA clinicians, submit applications to commercial and Medicaid payers including CAQH, NPI, PECOS, and individual payer portals, track credentialing statuses, follow up on delays, and maintain regular communication with insurance companies. They will also maintain up-to-date records of licensure, certifications, background checks, liability insurance, and other compliance documentation, coordinate start dates with HR and scheduling teams, ensure accuracy and timely submission of demographic updates, reassignment of benefits, and provider termination notices, monitor credentialing expiration dates and initiate renewals, assist billing team with credentialing-related claim denials and payer issues, and stay updated with payer policy changes and credentialing guidelines, especially those impacting ABA services.