Credentialing Specialist

Above and Beyond Therapy • Toms River, NJ

4d

About The Position

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.

Requirements

• 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.
• Proficiency with Microsoft Office and computer-based credentialing systems.

Nice To Haves

• Experience in ABA, behavioral health, mental health, or another healthcare setting is strongly preferred.
• 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

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed