Credentialing specialist Jobs in USA

Hours: Full Time (Monday – Friday/40hrs a week)
Office Location: El Segundo, CA (In-Person)
Compensation: $21.00 – $23.00 per/hour DOE

Behavior Frontiers is an industry leader in ABA (Applied Behavior Analysis) treatment for autism and other special needs. We are on a continuous journey to explore, assess, and develop only the highest quality ABA treatments and solutions delivered by best-in-class clinical professionals. We are rapidly expanding and seeking enthusiastic individuals who are ready to embark on a meaningful journey in one of the fastest growing fields in healthcare. Our recruiting position plays a critical role in our company and we need an individual with great interpersonal skills, detail oriented, is great at multi-tasking and time management.

How will you help create a World Without Limits:

• Facilitate end-to-end credentialing and enrollment processes for ABA providers with contracted health plans, ensuring timely and compliant submissions.
• Process and track initial credentialing and re-credentialing (reappointments) applications for clinicians across multiple insurance networks.
• Maintain accurate, up-to-date provider credentialing files, including but not limited to licenses (e.g., LBA), certifications (e.g., BCBA, RBT), and supporting documentation.
• Manage and update provider profiles in credentialing databases such as CAQH (Council for Affordable Quality Healthcare) to ensure data accuracy and completeness.
• Monitor credentialing statuses, proactively follow up on outstanding items, and ensure deadlines and payer requirements are met.
• Respond to internal and external requests for credentialing information, documentation, and status updates in a timely and professional manner.
• Coordinate cross-functionally with Recruitment, HR, Onboarding, Compliance, and Hiring Managers to communicate credentialing requirements, timelines, and status updates.
• Liaise with external vendors, payors, and regulatory agencies to facilitate credentialing, resolve issues, and ensure compliance with all applicable standards.
• Maintain strong attention to detail while managing multiple credentialing workflows, ensuring data integrity across systems and trackers.
• Support audits and compliance reviews by ensuring all credentialing documentation is complete, accurate, and readily accessible.
• Assist in developing, updating, and improving credentialing processes, SOPs, and tracking mechanisms.
• Provide administrative support across all aspects of credentialing operations.
• Any other duties as assigned

Qualifications and Skills:

• Bachelor's Degree preferred, but not necessary
• At least one year of Credentialing/Data Entry Experience
• Experience working with insurance networks, healthcare credentialing, or ABA providers preferred
• Excellent organizational skills with a strong ability to multi-task and navigate multiple systems simultaneously in a fast-paced environment.
• Proficiency in self-managing time and priorities
• Excellent customer service, must have exceptional communication skills over the phone and via email
• Exceptional attention to detail
• A professional, yet friendly demeanor
• Knowledge of Microsoft Office applications (e.g. Word, Excel, Outlook, Teams)
• Proficiency in data management and systems (e.g., CAQH, internal HRIS/credentialing trackers)

Why Behavior Frontiers is perfect for you:

• Competitive pay with optional On-demand paychecks thru DailyPay - get paid on your own schedule!
• 401K Plan with company match after 6 months of employment
• Paid Personal Time Off
• Paid Holidays
• Paid Sick Leave
• Medical, Dental and Vision insurance
• Opportunities for career advancement
• Performance and promotion raise
• Free Telehealth: Free 24/7 access to a doctor via telehealth for you and your dependents with no limits and no co-pays
• Free Telehealth Mental Health: Free access to a mental health counselor via telehealth for you and your dependents (over age 13) with no limits or co-pays
• Employee Assistance Program: Free access to some support services (financial, legal, counseling, etc.)
• Fitness: Discounted monthly gym membership to 12,000 gym locations nationwide, as well as free access to workout videos
• Deals: Exclusive discounts and savings to 500+ companies and more!
• Travel: Discounts on travel essentials including hotels, rental cars, flights, excursions, and more!
• Lab Testing Discounts: 10-80% off costs of routine lab work
• New Benefits Rx: Discounts on prescription medications from 10-80% at 60,000+ locations nationwide

Why work for Behavior Frontiers? Visit our benefits & perks page to learn more!

Behavior Frontiers is an Equal Opportunity Employer and will consider for employment all qualified applicants in a manner consistent with the requirements of the applicable federal, state, and local laws.