Credentialing Specialist

Atlanta Autism Center•Peachtree Corners, GA

21h•$50,000 - $65,000•Onsite

About The Position

The Credentialing Specialist is responsible for managing all aspects of payer and provider credentialing for Applied Behavior Analysis (ABA) and any other behavioral health services. This role ensures providers and locations are properly credentialed and enrolled with commercial and government payers, maintaining compliance with regulatory and contractual requirements to support uninterrupted billing and reimbursement.

Requirements

Bachelor’s degree
2+ years of ABA credentialing/enrollment experience required.
Knowledge of commercial insurance and Medicaid/CMO credentialing processes in the state of GA.
Strong attention to detail and organizational skills.
Ability to manage multiple deadlines and prioritize effectively.
Excellent communication and follow-up skills.
Proficiency in Microsoft Office and credentialing or billing systems.

Nice To Haves

Experience with CAQH, NPI, PECOS, and payer portals preferred.

Responsibilities

Coordinate and manage initial credentialing and recredentialing for ABA and other BH providers (e.g., BCBAs, RBTs).
Complete and submit provider enrollment applications with commercial insurance, Medicaid, and other payers.
Track credentialing status, expirations, and revalidation deadlines to ensure continuous network participation.
Maintain accurate provider data in credentialing systems, CAQH, and internal databases.
Serve as liaison with payers, providers, and internal teams to resolve credentialing and enrollment issues.
Support new location enrollments and updates (TIN/NPI changes, service additions, address changes).
Support new payer enrollments and updates (TIN/NPI changes, service additions, address changes).
Ensure compliance with payer, state, and accreditation requirements.
Maintain organized credentialing files and documentation audits.
Collaborate with clinical, operations, intake and revenue cycle teams to prevent service disruptions.
Stay current on payer requirements, regulatory updates, and credentialing best practices.