What are the responsibilities and job description for the ABA Credentialing Specialist position at LTE Care Plus?
LTE Care Plus, a growing provider of ABA services is looking for a seasoned credentialing specialist who will drive our business into new territories
As the Credentialing Specialist you will manage the enrollment of Applied Behavior Analysis practitioners and BCBAs with insurance payers, ensuring compliance with state and federal regulations to secure reimbursement. They will also handle applications, re-credentialing, CAQH profiles, and Medicaid enrollment for therapists. This role is vital for preventing revenue loss, with processes often taking 1–6 months per provider.
Key Responsibilities
Provider Credentialing & Contracting:
Submitting documentation for BCBAs, RBTs, and therapists to insurance panels.
Document Management: Maintaining updated records of licenses, certifications (BACB), NPI numbers, and insurance coverage.
Payer Relations: Acting as a liaison with insurance companies, handling CAQH profile setup, and managing Medicaid enrollments.Audit Readiness:
Ensuring all documentation meets compliance standards for audits
Re-credentialing: Tracking expiration dates to avoid lapses in authorization.
Required Skills and QualificationsKnowledge of Payer Policies: Familiarity with commercial insurance and Medicaid requirements for ABA therapy.Attention to Detail: Managing complex documentation for multiple providers.Communication Skills: Following up with insurance agents and providers.EHR/Software Proficiency: Experience with provider portals, Microsoft Office, and scheduling systems, specifically NYS Medicaid and MCOs.
Annual Salary will be commensurate with experience.
Schedule: Monday through Friday from 9am to 5:30pm Location: On Site
As the Credentialing Specialist you will manage the enrollment of Applied Behavior Analysis practitioners and BCBAs with insurance payers, ensuring compliance with state and federal regulations to secure reimbursement. They will also handle applications, re-credentialing, CAQH profiles, and Medicaid enrollment for therapists. This role is vital for preventing revenue loss, with processes often taking 1–6 months per provider.
Key Responsibilities
Provider Credentialing & Contracting:
Submitting documentation for BCBAs, RBTs, and therapists to insurance panels.
Document Management: Maintaining updated records of licenses, certifications (BACB), NPI numbers, and insurance coverage.
Payer Relations: Acting as a liaison with insurance companies, handling CAQH profile setup, and managing Medicaid enrollments.Audit Readiness:
Ensuring all documentation meets compliance standards for audits
Re-credentialing: Tracking expiration dates to avoid lapses in authorization.
Required Skills and QualificationsKnowledge of Payer Policies: Familiarity with commercial insurance and Medicaid requirements for ABA therapy.Attention to Detail: Managing complex documentation for multiple providers.Communication Skills: Following up with insurance agents and providers.EHR/Software Proficiency: Experience with provider portals, Microsoft Office, and scheduling systems, specifically NYS Medicaid and MCOs.
Annual Salary will be commensurate with experience.
Schedule: Monday through Friday from 9am to 5:30pm Location: On Site