Credentialing Specialist (Independent Contractor)Remote, Anywhere in the US

About the role

AnswersNow is looking to bring on a Credentialing Specialist as an independent contractor to coordinate and perform a variety of operational duties required for provider credentialing and enrollment. You will interact extensively with BCBAs, Care Coordinators, Health Plans, People Ops recruitment, clinical departments and leadership and will contribute significantly to the Company’s mission of delivering ABA therapy to every family who wants it by facilitating provider enrollment and maximizing reimbursement for services rendered.

What you'll do

• Work in conjunction with BCBAs to maintain CAQH profiles for clean credentialing.
• Maintain BCBA documentation to include onboarding documents needed for credentialing.
• Enroll providers with commercial and government payors; and revalidate providers with government and contracted health plans.
• Obtain, accurately complete, and submit enrollment applications and related documents to health plans.
• Audit payor directories for current and accurate provider information.
• Facilitate payor calls to address contracting and credentialing issues.
• Ensure all regulatory requirements are met with commercial health plans and state agencies.
• Prepare all commercial, Medicaid and/or third-party application forms required for credentialing and enrollment purposes for new providers; run reports and manage existing provider accounts for re-credentialing, re-validation and working expirables (e.g. licensure, certifications, credentials, etc.).
• Attend Health Plan training to keep Clinical and Ops teams informed of insurance process changes/requirements regarding provider enrollment.

About you

• Looking to join a mission-driven organization that is poised to shape the future of ABA service delivery
• Highly effective communicator who works to establish trust and team buy-in
• Takes pride in delivering high quality work
• Proactive problem-solver who takes the initiative to identify and resolve issues and operates with a sense of urgency
• Unafraid to ask questions, has a strong desire to learn and a passion for taking on new challenges
• Ability to manage multiple tasks simultaneously

Requirements

• 3 years of relevant experience in ABA credentialing preferred
• 1 year of previous ABA work experience is required
• 1 year of previous credentialing experience is required

Contract Terms

• This is an independent contractor position.
• Contract length: 6 months, with opportunity to transition into W2 employee (full-time)
• Hours: 30-40 hours per week
• Compensation: $25-30/hour