[Hiring] Credentialing Specialist @Little Leaves

Role Description

See how small steps bring big results for children, families, and team members alike. Work one-on-one with young children with autism to deliver individualized treatment designed by a Board-Certified Behavior Analyst. As a critical member of the child’s therapy team, you will:

• Facilitate learning and playing in groups
• Collect data
• Implement feedback from supervisors

Responsibilities

• Manage initial credentialing, recredentialing, and revalidation for all providers across multiple payers and states (MD, VA, FL)
• Maintain and update CAQH profiles, ensuring accuracy of provider demographics, licensure, and documentation
• Ensure providers are properly affiliated with correct TINs, service locations, and state licensure requirements
• Track and manage all applications using a centralized credentialing tracker
• Proactively follow up with payers on pending applications (30/60/90+ days)
• Escalate credentialing delays and unresolved issues through payer channels and leadership
• Collaborate with billing, authorization, and clinical teams to ensure providers are cleared for billing
• Identify and resolve credentialing discrepancies that may impact claims submission or reimbursement
• Maintain accurate documentation of credentialing activities in internal systems
• Support onboarding of new providers to ensure timely credentialing and minimal service disruption
• Assist with payer demographic updates, roster submissions, and contract-related updates
• Review and respond to payer correspondence related to credentialing status
• Perform audits to ensure alignment between credentialing records and billing systems
• Perform other duties as assigned

Qualifications

• 2+ years of provider credentialing experience (behavioral health or ABA preferred)
• Experience working with commercial payers (UHC/Optum, Aetna, Cigna, BCBS, Kaiser, etc.)
• Strong knowledge of CAQH management and provider enrollment processes
• Experience with multi-state credentialing (MD, VA, FL preferred)
• Understanding of state-specific licensure and payer enrollment requirements
• Highly organized with strong attention to detail and follow-through
• Strong communication and problem-solving skills
• Experience with practice management systems (e.g., Central Reach, Motivity) preferred
• Proficiency in Excel and tracking tools
• Ability to manage high-volume workflows and meet deadlines
• Ability to maintain confidentiality and comply with HIPAA regulations

Benefits

• Full insurance support to families who seek our services

Posted Salary Range

Starting from USD $26.45/Hr.