Authorization & Credentialing Specialist (ABA Billing)
Remote – Full-Time
About the Role
We are seeking an experienced Authorization & Credentialing Specialist to support our ABA billing operations by managing insurance authorizations, provider credentialing, and enrollment activities. In this role, you will be responsible for obtaining and renewing insurance authorizations, maintaining provider credentialing records, managing payer enrollments, and ensuring uninterrupted reimbursement by keeping provider and patient information current and compliant with payer requirements.
This role is ideal for professionals with a background in healthcare administration, medical billing, insurance authorizations, or credentialing who thrive in organized, process-driven environments and are committed to delivering accurate, compliant, and timely support with minimal supervision.
Key Responsibilities
Prior Authorizations — Obtain initial and ongoing insurance authorizations for ABA therapy services, proactively monitor authorization expiration dates, request renewals, and track remaining authorized units.
Insurance Verification — Verify patient eligibility and insurance benefits, communicate with insurance carriers regarding authorization requirements, and resolve authorization-related issues to prevent interruptions in patient care.
Provider Credentialing — Complete provider credentialing and recredentialing applications, maintain CAQH profiles, enroll providers with commercial insurance and Medicaid plans, and ensure provider records remain accurate and current.
Credentialing Maintenance — Monitor credentialing expiration dates, renew provider enrollments, maintain compliance documentation, and ensure all provider files remain audit-ready.
Documentation & Collaboration — Maintain accurate authorization and credentialing records, collaborate with billing and clinical teams to support uninterrupted services, resolve authorization and credentialing issues, and ensure compliance with payer and regulatory requirements.
Qualifications
Required
- Must be located in the United States.
- Minimum 2 years of authorization and credentialing experience.
- Previous ABA industry experience is required.
- Experience with insurance verification and prior authorizations.
- Knowledge of provider enrollment processes.
- Familiarity with CAQH and payer credentialing portals.
- Experience with CentralReach or similar ABA practice management systems.
- Strong organizational skills and attention to detail.
- Excellent communication and follow-up skills.
- Ability to work independently with minimal supervision.
Preferred
- Experience credentialing BCBAs and ABA providers.
- Medicaid enrollment experience.
- Familiarity with multiple commercial insurance payers.
- Strong knowledge of HIPAA compliance.
Performance Expectations
- Obtain and renew insurance authorizations in a timely manner.
- Maintain current provider credentialing with zero lapses.
- Ensure accurate tracking of authorization units and utilization.
- Successfully complete provider enrollments and recredentialing activities.
- Maintain complete and compliant credentialing documentation.
- Resolve authorization and credentialing issues promptly while minimizing interruptions to patient care.
Work Arrangement
- Fully Remote (US-Based)
- Full-Time Position
- Reliable internet connection and personal equipment required
- Ability to work independently with minimal supervision
What Success Looks Like
- Insurance authorizations are obtained and renewed before services are impacted.
- Provider credentialing remains current with no lapses or expired enrollments.
- CAQH profiles and provider documentation are accurate and fully maintained.
- Authorization tracking is complete, with remaining units monitored appropriately.
- Provider enrollments are processed efficiently and accurately.
- Billing and clinical teams experience minimal service interruptions due to authorization or credentialing issues.
- All documentation remains compliant, organized, and audit-ready.