Caqh Remote Jobs in Spring Valley, NY (NOW HIRING)

Pay: $21–$28 per hour (DOE)

RightWay ABA is a growing Applied Behavior Analysis (ABA) therapy practice serving families across New Jersey through five center locations—Paramus, Piscataway, Jersey City, Pompton Plains, and Tinton Falls—as well as in-home and daycare-based services.

We're expanding our in-house revenue cycle team and are seeking a detail-oriented Credentialing & VOB/Authorizations Specialist to take ownership of provider credentialing, benefits verification, and authorization workflows in a fully remote environment.

The Credentialing & VOB/Authorizations Specialist will manage provider credentialing, verification of benefits, and prior authorization submissions to ensure clinicians remain actively paneled and clients can begin services without delay. This role works closely with the Director of Billing and Intake team and offers clear ownership of a critical function within the organization.

Benefits & Perks

• Unlimited PTO — Enjoy flexible, unlimited paid time off, provided weekly, monthly, and annual billable requirements are consistently met.

• 401(k) Retirement Plan — Invest in your future with access to our company-sponsored 401(k) program.

• Comprehensive Health Coverage — Medical, dental, and vision insurance available to all eligible full-time employees, with the company covering a portion of the monthly premium.

• Fully remote
  

• Manage provider credentialing and recredentialing with commercial payers and Medicaid MCOs, including initial applications, CAQH maintenance, revalidations, and roster updates.

• Verify patient benefits, including deductibles, coinsurance, out-of-pocket maximums, and ABA-specific coverage details.

• Submit and track initial and renewal prior authorizations for ABA services.

• Monitor authorization expiration dates and proactively coordinate renewals to prevent gaps in care.

• Maintain accurate payer, provider, and authorization records within the practice management system.

• Communicate with payers to resolve credentialing delays, panel status inquiries, and benefit discrepancies.

• Partner with billing and intake teams through phone, email, and workflow tools to identify and resolve coverage issues early.

• Minimum of 2 years of experience in healthcare credentialing, verification of benefits, and/or prior authorizations.

• Working knowledge of commercial and Medicaid payer processes, CAQH, and authorization workflows.

• Strong attention to detail and the ability to manage deadlines across multiple providers and payers.

• Excellent written and verbal communication skills.

• Ability to work independently and remain organized in a remote environment.

• Reliable high-speed internet connection and a private, HIPAA-compliant workspace.

• Experience in ABA or behavioral health settings.

• Familiarity with New Jersey payers, including Horizon, Aetna, UnitedHealthcare, and Medicaid MCOs.

• Experience using EMR/practice management systems and workflow tools such as Monday.com.

• Knowledge of ABA service authorization requirements and CPT codes, including 97151, 97153, 97155, and 97156.

To apply, please submit your resume along with a brief note describing your relevant experience.

RightWay ABA is an Equal Opportunity Employer