Credentialing Specialist

Job Description

Job Description

A healthcare company is seeking an experienced Credentialing Specialist to join its team in El Segundo, California. The Credentialing Specialist will bring strong high-volume credentialing experience, including knowledge of ABA provider credentialing processes, and will help bring structure and organization to a busy department.

Key Responsibilities:

• Process provider, physician, and ABA practitioner credentialing files from intake through completion, ensuring accuracy and timely follow-up.
• Review applications, supporting documents, licensure records, and certifications to confirm all required information is complete, current, and compliant.
• Manage initial credentialing and re-credentialing activities by tracking renewal timelines and coordinating document collection ahead of deadlines.
• Communicate with providers, clinicians, internal departments, and external entities to resolve missing information and clear outstanding items.
• Support credentialing functions related to ABA services, including working with behavior analysts, therapists, and related provider documentation as needed.
• Maintain organized credentialing records and update status details across departmental systems and tracking tools.
• Prioritize backlog work effectively while meeting established turnaround times in a fast-paced healthcare environment.
• Assist with credentialing-related process improvement, clean-up efforts, and additional departmental support needs as identified.

Benefits: Health, Dental, Vision, 401k, and Sick Time Off.

Qualifications:

• Hands-on experience in healthcare credentialing, including provider, physician, and ABA credentialing workflows.
• Strong understanding of credentialing and re-credentialing requirements, documentation standards, and verification practices, including those related to ABA providers and clinicians.
• Experience working with ABA-related provider documentation, licensure, certifications, and enrollment processes preferred.
• Ability to begin contributing with minimal training and work effectively in a fully onsite environment.
• Proven attention to detail with the ability to manage multiple files and deadlines accurately.
• Strong communication skills for coordinating with providers, clinicians, and internal stakeholders.
• Proficiency in maintaining organized records and tracking case progress throughout the credentialing process.