Credentialing Specialist - Hi-5 ABA Processing
Credentialing Specialists are highly essential in the healthcare/Applied Behavior Analysis (ABA) industry because they’re responsible for verifying that clinicians and other medical personnel have the appropriate licensing to work in their fields. They also ensure facilities comply with and follow all state and federal guidelines.
Credentialing Specialists provide administrative support & their job is to verify that all medical staff members’ credentials and licenses are valid and up to date. They operate and maintain databases and advise staff members on renewal dates for licenses and credentials to help ensure they can continue to work legally without lapses. This requires a lot of follow up, tracking, and being efficient. They must research to ensure they’re up to date on medical policy, local licensing and certification requirements.
Duties / Responsibilities:
- Create and maintain licensing, credentials and insurance records for a nation-wide ABA Network.
- Conduct research and remain current on state and federal regulations and policies
- Release information to requesting agencies and public inquiries when required by law
- Help develop internal credentialing processes
- Monitor license and credential expiration dates and advise staff members of required renewal dates
- Ensure the facility and staff members are maintaining compliance with regulatory and accrediting institutions
Skills / Qualifications:
- Strong written and verbal communication skills; sharing information across a franchise network of healthcare professionals.
- Ability to meet strict deadlines
- Attention to detail
- Knowledgeable in policies, laws and procedures
- Strong computer skills
- Proficiency in database management (if applicable)
- Willingness to work as a team player
- Good organizational skills
Experience:
Applicants need five plus years of previous employment in medical, clinical, healthcare administration as a Credentialing Specialist, and a strong knowledge of data systems. Credentialing Specialists must often maintain large databases containing confidential employee information, so previous experience creating databases and/or inputting data (data entry) is preferred. The individual needs experience with NPPES, CAQH, and payor portals across the country.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work Location: Remote