Credentialing Assistant

Department: Revenue Cycle / Compliance / Human Resources

Reports To: Credentialing Manager / Revenue Cycle Director / HR Director FLSA Status: Exempt

Position Summary The Credentialing Assistant supports the credentialing and re-credentialing processes for clinical staff within the ABA therapy organization. This role ensures that all providers meet payer and regulatory requirements to deliver and bill for services. The Credentialing Assistant maintains accurate records, tracks application statuses, and collaborates with internal teams and insurance payers to ensure timely credentialing and enrollment.

Key Responsibilities

Credentialing & Enrollment Support

● Assist with initial credentialing and re-credentialing for clinical staff, including: ○ Board Certified Behavior Analysts (BCBAs)

○ Board Certified Assistant Behavior Analysts (BCaBAs)

○ Registered Behavior Technicians (RBTs), as required by payers

● Prepare and submit provider enrollment applications to insurance payers (Medicaid, commercial plans, TRICARE)

● Gather and verify required documentation, such as:

○ Licenses and certifications

○ Education and training records

○ Work history and references

● Maintain credentialing files and ensure completeness and accuracy

Tracking & Data Management

● Maintain credentialing databases and tracking systems

● Monitor application and re-credentialing timelines to ensure timely submission and follow-up

● Track expirations for licenses, certifications, and payer enrollments

● Ensure all provider information is up to date in internal systems and payer portals Payer Communication

● Communicate with insurance companies to verify application status and resolve issues ● Follow up on pending applications and escalate delays as needed

● Respond to payer requests for additional information in a timely manner Compliance & Documentation

● Ensure compliance with payer, state, and federal requirements





● Maintain organized and audit-ready credentialing records

● Support internal and external audits by providing required documentation ● Adhere to HIPAA guidelines in handling sensitive provider information

Cross-Functional Collaboration

● Partner with HR and Hiring teams to initiate credentialing for new hires ● Collaborate with Clinical and Operations teams to ensure providers are credentialed prior to service delivery

● Coordinate with Billing and Revenue Cycle teams to ensure providers are properly enrolled for reimbursement

Process Improvement

● Identify opportunities to improve credentialing workflows and tracking systems ● Assist in maintaining credentialing policies and procedures

● Support implementation of credentialing software or system enhancements Qualifications

Required

● High school diploma or equivalent (Associate or Bachelor’s degree preferred) ● 1–3 years of administrative, credentialing, or healthcare support experience ● Strong organizational skills and attention to detail

● Proficiency with Microsoft Office and data entry systems

Preferred

● Experience in healthcare credentialing, provider enrollment, or ABA therapy services ● Familiarity with insurance payer processes (Medicaid, commercial plans, TRICARE) ● Experience with credentialing software or databases (e.g., CAQH)

● Knowledge of licensing and certification requirements for ABA providers Key Competencies

● High level of accuracy and attention to detail

● Solid organizational and time management skills

● Ability to manage multiple deadlines and priorities

● Effective written and verbal communication

● Problem-solving and follow-through

● Ability to handle confidential information with professionalism Work Environment

● Office or hybrid setting with potential remote flexibility ● Frequent collaboration with HR, clinical, and revenue cycle teams ● Detail-oriented, deadline-driven environment

Physical Requirements

● Prolonged periods of sitting and computer use

● Ability to occasionally lift up to 15 pounds

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📌 Credentialing Assistant (Bengaluru)
🏢 Ārohana Support
📍 Bengaluru