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Full-time
bachelor degree
Health Insurance, Dental Insurance, Chiropractic Insurance, Vision Insurance, Critical Illness Insurance, Voluntary Life Insurance
Posted 18h ago
~40 hrs/week
Remote in United States
Responsibilities
The Credentialing Specialist coordinates provider credentialing, re-credentialing, and payer enrollment activities across multiple states. They also ensure compliance with federal, state, and payer requirements while maintaining accurate provider records and documentation.
Requirements
Candidates should have a bachelor's degree in a related field and a minimum of 2 years of experience in provider credentialing or healthcare enrollment. Proficiency with credentialing platforms like CAQH and strong organizational skills are essential for this role.
Full job description
Join Our Team as a Credentialing Specialist at Behavioral Health Works!
About Us
Behavioral Health Works is an expanding company dedicated to responsible and sustainable growth. We are committed to delivering personalized ABA therapy for children and adolescents diagnosed with Autism Spectrum Disorder (ASD). ABA therapy helps individuals with Autism improve socially significant behavior, following the principles of Behavior Analysis. Our extensively trained BCBAs, Case Supervisors and Technicians collaborate closely with parents to create tailored treatment plans that address the distinct requirements of each child.
The Role
Behavioral Health Works is seeking a detail-oriented and organized Credentialing Specialist to support provider credentialing, enrollment and compliance activities across our growing multi-state organization.
This fully remote position is responsible for coordinating provider credentialing and re-credentialing, managing payer enrollments, maintaining provider records and ensuring compliance with federal, state and payer requirements. The Credentialing Specialist will work closely with clinical, operations, billing and compliance teams to ensure providers are credentialed and enrolled accurately and efficiently so they can begin serving clients without delay.
What We Offer Our Employees
100% Remote Work Environment
Competitive salary starting at $60,000 annually
Comprehensive benefits package
Opportunities for professional development and career growth
Collaborative and supportive work culture
Benefits for Full-Time Employees
Health, Dental, Chiropractic and Vision Insurance
Critical Illness, Voluntary Life, Accident, Hospital Confinement and Basic Life Insurance
401(k)
Pet Insurance
Paid Time Off
7 Company-Paid Holidays per year
Professional Development Assistance
Employee Referral Program
Tuition Reduction Programs through affiliated university partners
Key Responsibilities
Provider Credentialing & Enrollment
Coordinate provider credentialing and re-credentialing for BCBAs and other clinical providers across multiple states.
Prepare, submit and track credentialing and enrollment applications with Medicaid, Medicare and commercial insurance payers.
Maintain provider records including licenses, certifications, malpractice insurance and credentialing documentation.
Monitor credentialing applications and proactively follow up with payers regarding application status.
Complete provider revalidations and re-credentialing renewals before required deadlines.
Maintain provider profiles within CAQH, NPPES, CMS I&A, Availity and other credentialing platforms.
Compliance & Documentation
Ensure provider files remain complete, accurate and compliant with federal, state and payer requirements.
Monitor provider licenses, certifications and credential expiration dates.
Perform routine audits of provider files and credentialing records.
Assist with monitoring OIG exclusions, SAM, state license sanctions and Medicare/Medicaid Opt-Out status.
Maintain organized electronic credentialing files and documentation.
Provider & Payer Support
Serve as a primary point of contact for providers regarding credentialing and enrollment questions.
Communicate with insurance companies, Medicaid agencies and commercial payers regarding application status and required documentation.
Assist providers with completing credentialing paperwork and obtaining required documents.
Resolve credentialing issues and enrollment discrepancies promptly.
Reporting & Process Improvement
Track credentialing and enrollment status using spreadsheets and internal systems.
Prepare reports on credentialing activities, enrollment status and upcoming renewals.
Identify opportunities to improve credentialing workflows and operational efficiency.
Assist with maintaining SOPs, policies and credentialing documentation.
Support accreditation and audit preparation as assigned.
Qualifications
Bachelor's degree in Healthcare Administration, Business Administration, Public Health or a related field preferred, or equivalent work experience.
Minimum of 2 years of provider credentialing or healthcare enrollment experience.
Experience with Medicaid, Medicare and commercial payer credentialing.
Experience using CAQH, NPPES, CMS I&A, Availity or similar credentialing platforms.
Strong understanding of provider credentialing and payer enrollment processes.
Excellent organizational skills and attention to detail.
Strong written and verbal communication skills.
Proficiency with Google Workspace (Drive, Sheets, Forms) and Microsoft Office, including Excel, monday.com.
Preferred Qualifications
Experience in ABA, behavioral health or outpatient healthcare.
Experience with CentralReach or similar practice management software.
Experience with multi-state provider credentialing and enrollment.
Knowledge of accreditation standards and healthcare compliance requirements.
Experience with state-specific provider enrollment portals (e.g., PAVE for California Medi-Cal, EICS for Massachusetts Early Intervention).
Join Behavioral Health Works!
If you're passionate about organization, compliance and supporting providers behind the scenes, we'd love to hear from you. Join Behavioral Health Works and help ensure our clinicians are credentialed efficiently so they can focus on delivering exceptional care to children and families across the country.
Behavioral Health Works (BHW) is redefining what quality autism care looks like by putting clinical integrity, meaningful outcomes, and people first.
We partner with families, schools, and communities to deliver individualized, evidence-based services rooted in Applied Behavior Analysis (ABA). But we don’t measure success by hours or checkboxes we measure it by real progress in everyday life.
At BHW, we believe:
• Clinical decisions should be driven by need not numbers
• Strong outcomes come from supported, well-trained clinicians
• Families deserve transparency, consistency, and collaboration
We’ve built our model around these beliefs by investing in our clinicians, strengthening supervision and training, and creating systems that support both quality care and sustainable growth.
Our services include ABA and parent training across home, school, and community settings, with a focus on practical, compassionate, and individualized care.
As we grow, our mission stays the same:
Deliver ethical, high-quality care while building a culture where clinicians feel valued, supported, and empowered to do their best work.
Offices: 1301 E Orangewood Ave, Anaheim, California 92805, US · 1508 W. Artesia Square, Suite B, Gardena, California 90248, US · 3281 E. Guasti Rd, Suite 705, 707, 709, Ontario, California 91761, US · 9655 Granite Ridge Dr, Suite 2073, San Diego, California 92123, US · 303 Wyman Street, Suite 300, Waltham, Massachusetts 02451, US
ABASpeechand Occupational TherapiesSocial Skills GroupsParent Trainings/WorkshopsIndividual & Family CounselingOccupational Programs for Individuals with DisabilitiesMultidisciplinary-Developmental EvaluationsCommunity & Global Outreach ProgramsFunctional Behavior Asessment
Behavioral Health Works (BHW) is redefining what quality autism care looks like by putting clinical integrity, meaningful outcomes, and people first.
We partner with families, schools, and communities to deliver individualized, evidence-based services rooted in Applied Behavior Analysis (ABA). But we don’t measure success by hours or checkboxes we measure it by real progress in everyday life.
At BHW, we believe:
• Clinical decisions should be driven by need not numbers
• Strong outcomes come from supported, well-trained clinicians
• Families deserve transparency, consistency, and collaboration
We’ve built our model around these beliefs by investing in our clinicians, strengthening supervision and training, and creating systems that support both quality care and sustainable growth.
Our services include ABA and parent training across home, school, and community settings, with a focus on practical, compassionate, and individualized care.
As we grow, our mission stays the same:
Deliver ethical, high-quality care while building a culture where clinicians feel valued, supported, and empowered to do their best work.
Offices: 1301 E Orangewood Ave, Anaheim, California 92805, US · 1508 W. Artesia Square, Suite B, Gardena, California 90248, US · 3281 E. Guasti Rd, Suite 705, 707, 709, Ontario, California 91761, US · 9655 Granite Ridge Dr, Suite 2073, San Diego, California 92123, US · 303 Wyman Street, Suite 300, Waltham, Massachusetts 02451, US
ABASpeechand Occupational TherapiesSocial Skills GroupsParent Trainings/WorkshopsIndividual & Family CounselingOccupational Programs for Individuals with DisabilitiesMultidisciplinary-Developmental EvaluationsCommunity & Global Outreach ProgramsFunctional Behavior Asessment