Behavioral Framework, LLC
Healthcare Credentialing Specialist
Behavioral Framework, LLC, Rockville, Maryland, us, 20849
Credentialing and Licensing Coordinator page is loaded## Credentialing and Licensing Coordinatorlocations:
Headquarterstime type:
Full timeposted on:
Posted Yesterdayjob requisition id:
JR101074**Behavioral Framework** – the leading provider of ABA therapy to children diagnosed with autism in the DMV area – is looking for an experienced **Credentialing and Licensing****Coordinator.**The **Credentialing and Licensing****Coordinator** is responsible for supporting the full range of provider licensing, credentialing and re-credentialing functions for both BCBAs and technicians. This role ensures timely, accurate submission and maintenance of credentialing information with all commercial and government payers. The Credentialing and Licensing Coordinator will work closely with the Credentialing Manager and internal stakeholders to maintain compliance, reduce denials, and ensure providers are authorized to deliver billable services.**Behavioral Framework Highlights:*** Behavioral Framework is devoted to the pursuit of providing excellent, honest, and compassionate care within the autism community.* We believe in the dedication and passion of our professional team and the science behind ABA to make a difference in the families and children we serve.* Ranked on the Inc. 5000 list for 3 consecutive years.* 1 of 4 Autism providers in the country to earn 3-year accreditation + telehealth from the Behavioral Health Center of Excellence* Beautiful new office 2 minutes from I-270**Key Responsibilities*** Manage the initial application and renewal process for state licenses for individual providers and facilities across multiple states* Process initial licensing, credentialing and re-credentialing applications for all providers with commercial and government payers.* Maintain and update licensing and credentialing records, documentation, and databases with a high degree of accuracy.* Monitor licensing and credentialing status and proactively follow up on outstanding applications to ensure timely approval.* Assist providers with establishing, updating, and maintaining CAQH profiles.* Generate regular and ad hoc credentialing reports, including identification of providers who are not yet credentialed, status of active billing vs. authorized billing, and upcoming expirations.* Collaborate with internal teams to ensure providers are appropriately credentialed prior to delivering services.* Support credentialing audits, payer inquiries, and compliance reviews as needed.* Serve as onsite support when the Credentialing Manager is out of the office.* Perform other duties as assigned.**Knowledge, Skills & Experience*** Strong organizational and time-management skills; able to prioritize and manage deadlines in a high-volume environment.* Prior experience in medical or behavioral health provider credentialing required.* Working knowledge of Medicaid, commercial insurance regulations, and payer-specific credentialing processes.* Experience working with insurance companies and/or third-party administrators.* High attention to detail and accuracy; strong follow-through.* Ability to maintain confidentiality and adhere to all HIPAA guidelines and regulations.* Excellent research, analytical, and basic math skills.* Proficiency in Microsoft Office Suite; experience with credentialing software or databases preferred.* Minimum high school diploma required; associate or bachelor’s degree preferred.* Knowledge of behavioral health industry terminology and ABA services preferred.**Work Environment & Physical Requirements*** Ability to work in a fast-paced, deadline-driven environment.* Must be able to work 40 hours per week onsite in the Rockville, MD office.* Ability to work cooperatively with team members across departments.* Must comply with all company policies and procedures.* Regular activities include sitting for extended periods, walking, bending, and occasional kneeling.* Must be able to reach, pull, push, and lift up to 15 lbs.* Requires manual dexterity as well as adequate auditory and visual abilities.Salary: $50,000-$55,000EOE*Behavioral Framework is committed to equitable treatment for all employees, clients, and their families. We welcome and respect the diversity of the families we serve, and we focus our organizational efforts to build a culture of respect, dignity, fairness, caring, equality, and self-esteem.**We believe our strength comes from the shared experiences of our employees, clients, and community. We pride ourselves on serving a diverse population and always seeking to hire, retain, and promote from a wide variety of backgrounds.**#BFADMIN***Changing Lives One Child At a Time**Joining Behavioral Framework is about more than a job — it's an opportunity to make a positive impact on your clients, their families, and the community. You get the opportunity to be a part of transformative moments in the lives of individuals with Autism and related disorders. Whether you’re starting your career or have experience, you’ll engage in meaningful work that brings life-changing rewards. #J-18808-Ljbffr
Headquarterstime type:
Full timeposted on:
Posted Yesterdayjob requisition id:
JR101074**Behavioral Framework** – the leading provider of ABA therapy to children diagnosed with autism in the DMV area – is looking for an experienced **Credentialing and Licensing****Coordinator.**The **Credentialing and Licensing****Coordinator** is responsible for supporting the full range of provider licensing, credentialing and re-credentialing functions for both BCBAs and technicians. This role ensures timely, accurate submission and maintenance of credentialing information with all commercial and government payers. The Credentialing and Licensing Coordinator will work closely with the Credentialing Manager and internal stakeholders to maintain compliance, reduce denials, and ensure providers are authorized to deliver billable services.**Behavioral Framework Highlights:*** Behavioral Framework is devoted to the pursuit of providing excellent, honest, and compassionate care within the autism community.* We believe in the dedication and passion of our professional team and the science behind ABA to make a difference in the families and children we serve.* Ranked on the Inc. 5000 list for 3 consecutive years.* 1 of 4 Autism providers in the country to earn 3-year accreditation + telehealth from the Behavioral Health Center of Excellence* Beautiful new office 2 minutes from I-270**Key Responsibilities*** Manage the initial application and renewal process for state licenses for individual providers and facilities across multiple states* Process initial licensing, credentialing and re-credentialing applications for all providers with commercial and government payers.* Maintain and update licensing and credentialing records, documentation, and databases with a high degree of accuracy.* Monitor licensing and credentialing status and proactively follow up on outstanding applications to ensure timely approval.* Assist providers with establishing, updating, and maintaining CAQH profiles.* Generate regular and ad hoc credentialing reports, including identification of providers who are not yet credentialed, status of active billing vs. authorized billing, and upcoming expirations.* Collaborate with internal teams to ensure providers are appropriately credentialed prior to delivering services.* Support credentialing audits, payer inquiries, and compliance reviews as needed.* Serve as onsite support when the Credentialing Manager is out of the office.* Perform other duties as assigned.**Knowledge, Skills & Experience*** Strong organizational and time-management skills; able to prioritize and manage deadlines in a high-volume environment.* Prior experience in medical or behavioral health provider credentialing required.* Working knowledge of Medicaid, commercial insurance regulations, and payer-specific credentialing processes.* Experience working with insurance companies and/or third-party administrators.* High attention to detail and accuracy; strong follow-through.* Ability to maintain confidentiality and adhere to all HIPAA guidelines and regulations.* Excellent research, analytical, and basic math skills.* Proficiency in Microsoft Office Suite; experience with credentialing software or databases preferred.* Minimum high school diploma required; associate or bachelor’s degree preferred.* Knowledge of behavioral health industry terminology and ABA services preferred.**Work Environment & Physical Requirements*** Ability to work in a fast-paced, deadline-driven environment.* Must be able to work 40 hours per week onsite in the Rockville, MD office.* Ability to work cooperatively with team members across departments.* Must comply with all company policies and procedures.* Regular activities include sitting for extended periods, walking, bending, and occasional kneeling.* Must be able to reach, pull, push, and lift up to 15 lbs.* Requires manual dexterity as well as adequate auditory and visual abilities.Salary: $50,000-$55,000EOE*Behavioral Framework is committed to equitable treatment for all employees, clients, and their families. We welcome and respect the diversity of the families we serve, and we focus our organizational efforts to build a culture of respect, dignity, fairness, caring, equality, and self-esteem.**We believe our strength comes from the shared experiences of our employees, clients, and community. We pride ourselves on serving a diverse population and always seeking to hire, retain, and promote from a wide variety of backgrounds.**#BFADMIN***Changing Lives One Child At a Time**Joining Behavioral Framework is about more than a job — it's an opportunity to make a positive impact on your clients, their families, and the community. You get the opportunity to be a part of transformative moments in the lives of individuals with Autism and related disorders. Whether you’re starting your career or have experience, you’ll engage in meaningful work that brings life-changing rewards. #J-18808-Ljbffr