Credentialing Specialist

ABS Kids is looking for a Credentialing Specialist to join our team! In this role you will play a vital part in the delivery of ABA therapy to children with Autism Spectrum Disorder, by helping to credential our providers with various insurance programs.

Our Administrative Support team members play a vital role in advancing our mission to make a difference in the lives of children with autism spectrum disorder and their families. Every team member at ABS Kids is passionate about providing best in class support to our direct care providers, who in turn deliver the highest quality ABA therapy to our patients.

What would you do?

• Prepare clinician applications, including supporting documentation, to applications as required and maintain information databases for qualified providers/consultants.
• Coordinate internally with providers to obtain new and updated documentation required for credentialing and recredentialing.
• Implement policies, procedures and processes to ensure timely and efficient credentialing/recredentialing.
• Submit completed credentialing payor applications for providers/consultants and track length of time for credentialing and recredentialing processes.
• Follow up with insurance companies weekly to track enrollment progress of providers/consultants and document conversations.
• Maintain provider/consultant rosters for payors weekly/monthly submissions and contractual requests.
• Responsible for managing multiple projects and requests from the Manager of Credentialing.
• Meet deadlines and communicate updates regularly with Manager of Credentialing and internal clients.
• Record and log all data in credentialing software in order to review daily performance, ensure compliance and identify conflicts or changes requiring resolution from Manager of Credentialing.
• Analyze situations, identify problems, and recommend solutions to Manager of Credentialing.
• Answer emails, maintain contact lists, and be a point of contact for internal and external clients.
• Prepare reports, memos, documents and sort incoming mail, faxes, and courier deliveries for distribution.

Why work for ABS Kids?

• Opportunities for career advancement
• Medical, dental and vision insurance
• Paid Time Off / Paid Holidays
• 401k Plan with employer match

Who We Are:

• ABS Kids is dedicated to empowering children with autism spectrum disorders and their families to reach their full potential - helping them learn, grow and reach incredible milestones.
• We take pride in our stellar support for providers, so they can do what they do best - deliver the highest quality ABA Therapy to our patients.
• At ABS Kids we are empowered by the breadth of our differences. Our mission is to create a culture where all people thrive because their diverse stories are heard and celebrated. We commit to an evolving understanding of diversity as we learn from one another.
• We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.

Who are we looking for?

• 2 or more years of credentialing/enrollment experience.
• Excellent verbal and written communication skills, including ability to compile, interpret and utilize information; and to communicate effectively with people of all demographics and education levels.
• Ability to work with minimal supervision, use good judgment, meet deadlines and prioritize workloads.
• Ability to maintain confidentiality.
• Well organized and have excellent attention to detail.
• Computer literacy - Intermediate level working with Windows Office and Google applications, preferred.
• Data entry experience.
• Ability to solve problems and reason deduction.
• Bachelor's degree.
• Experience with E-VIPS credentialing software, NPI registry, and CAQH.