ABA Program Operations & Credentialing Coordinator

Job title: ABA Program Operations & Credentialing Coordinator

Type of employment: Part-time

Shift Schedule: 10:00 AM - 2:00 PM EST

High-Level Summary

Support the day-to-day operations and continued growth of the company’s Applied Behavior Analysis (ABA) program through credentialing, provider enrollment, referral coordination, EHR administration, client workflow management, provider support, and program administration.

This role will serve as a central point of coordination between management, BCBAs, RBTs, service coordinators, case managers, referral sources, payers, recruiting, billing, and other internal stakeholders.

The person in this role will help manage clients from referral through service initiation, maintain provider and credentialing requirements, follow up on outstanding items, support ABA program workflows, and assist with the company’s Autism Waiver program and other operational needs when required.

The ideal candidate has direct ABA experience, understands healthcare credentialing and provider enrollment, is highly organized, communicates confidently with external stakeholders, and can independently research requirements and manage multiple workflows without constant direction.

About the Company:

The company provides autism-related healthcare and developmental disability services, including Applied Behavior Analysis and Autism Waiver services.

The organization is continuing to develop and expand its ABA program and needs a strong operations professional who can help maintain the administrative infrastructure required to support clients, providers, payer relationships, and service delivery.

Company core values:

• Accuracy and compliance — committed to maintaining complete, accurate, and up-to-date provider and program documentation.
• Confidentiality — protects sensitive healthcare, provider, and organizational information with professionalism and discretion.
• Accountability — takes ownership of applications, deadlines, follow-ups, and outstanding requirements.
• Organization and consistency — values structured processes, accurate tracking, and reliable execution.
• Proactive collaboration — communicates regularly with internal staff, providers, payers, and referral sources to keep processes moving.

Core Responsibilities

ABA Credentialing & Provider Enrollment

• Manage initial credentialing, enrollment, recredentialing, and provider documentation.
• Complete and submit organizational and individual provider applications.
• Coordinate credentialing requirements for BCBAs, RBTs, and other applicable providers.
• Communicate directly with Medicaid programs, managed care organizations, commercial insurers, and credentialing departments.
• Track credentialing applications, payer effective dates, expiration dates, licenses, certifications, liability insurance, recredentialing deadlines, and outstanding requirements.
• Maintain organized credentialing trackers and provider files.
• Support payer expansion in Maryland and additional networks.
• Assist with Optum credentialing and enrollment.
• Maintain requirements related to Health Services for Children with
• Special Needs (HSCSN) and other payer relationships.
• Manage CAQH, NPI/NPPES, payer portals, provider rosters, W-9s, EFT/ERA enrollment, and related documentation.
• Follow up consistently on pending applications until resolution.
• Identify upcoming credentialing and recredentialing requirements before deadlines become urgent.

ABA Program Operations

• Help establish, document, and maintain ABA operational workflows.

• Manage administrative processes across the client lifecycle:

Referral - Intake - Assessment - Authorization - Staffing - Service Initiation

• Monitor outstanding requirements that may delay client services.
• Coordinate with BCBAs, RBTs, recruiting, billing, and leadership.
• Follow up with BCBAs regarding assessments, treatment plans, authorizations, reauthorizations, documentation, and client readiness.
• Follow up with providers and staff regarding missing or incomplete documentation.
• Develop and maintain SOPs, checklists, trackers, and internal workflows.
• Identify operational gaps and recommend practical process improvements.
• Provide management with regular updates regarding client status, credentialing, referrals, authorizations, staffing, and outstanding items.

New Client Workflow & Provider Coordination

• Manage administrative workflows for new ABA referrals.
• Track prospective clients from referral through service initiation.
  Coordinate administrative requirements related to BCBA and RBT assignments.
• Track clients waiting for intake, assessment, authorization, staffing, documentation, or service start.
• Communicate staffing needs to recruiting and talent acquisition.
• Confirm required documentation is complete before services begin.
• Maintain clear visibility into the status and next step for each prospective and active client.

EHR Administration

• Create and maintain client profiles.

• Create and maintain BCBA and RBT profiles.

• Enter and update client and provider information.

• Enter and monitor authorizations.

• Assist with provider assignments, scheduling, and service setup.

• Maintain service codes and related program information.

• Manage appropriate permissions and access as assigned.

• Monitor the EHR for missing, outdated, or inaccurate information.

• Assist with correcting discrepancies.

• Support improvements to EHR workflows.

• Maintain supplemental trackers where needed.

• Communicate with service coordinators, case managers, referral sources, and community partners.
• Maintain referral and coordinator contact lists.
• Send program information, introductory communications, and follow-ups.
• Make outreach calls when appropriate.
• Distribute referral materials.
• Track outreach attempts, responses, referrals, follow-up dates, and next steps.
• Maintain communication with coordinators regarding service availability and client needs.
• Prevent potential referrals from being lost due to incomplete follow-up.

Autism Waiver Administrative Support 

• Support participant and staff file maintenance.

• Assist with intake and onboarding documentation.

• Track outstanding participant and staff requirements.

• Support authorization tracking and expiration monitoring.

• Assist with EHR and administrative data entry.

• Maintain program spreadsheets and trackers.

• Support scheduling and coordination.

• Follow up with service coordinators, families, staff, and other stakeholders as assigned.
• Support documentation reviews, audits, compliance checks, and file organization.
• Prepare internal reports and administrative data.
• Develop and maintain program SOPs and checklists.
• Monitor program deadlines and outstanding requirements.

Additional Program Support

As operational needs arise, support other company programs through:

• Data entry and documentation management
• EHR updates
• File organization
• Spreadsheet and tracker maintenance
• Staff and client follow-up
• Scheduling support
• Internal reporting
• Audit and file review support
• New program setup
• Workflow and SOP development
• Special projects
• Cross-department coordination

Required Qualifications

• Direct professional experience within Applied Behavior Analysis (ABA).
• Hands-on healthcare credentialing and provider enrollment experience.
• Experience credentialing BCBAs, RBTs, or behavioral health providers.
• Experience with Medicaid, managed care organizations, and/or commercial payers.
• Experience with CAQH, NPI/NPPES, payer portals, or similar credentialing systems.
• Strong EHR experience.
• Experience supporting referrals, intake, authorizations, provider onboarding, or healthcare program operations.
• Strong spreadsheet and tracking skills using Google Sheets, Excel, or similar systems.
• Strong written and verbal English communication.
• Comfortable communicating directly with payers, providers, coordinators, staff, and external organizations.
• Strong follow-through and ability to manage multiple cases and deadlines simultaneously.
• Ability to independently research unfamiliar requirements and work with limited supervision.

Preferred Qualifications

• Experience with Maryland Medicaid or Maryland-based ABA services.
• Experience with Autism Waiver or Medicaid-funded programs.
• Optum credentialing experience.
• HSCSN experience.
• Experience with EFT/ERA enrollment.
• Experience supporting audits, compliance reviews, or quality checks.
• Experience building SOPs, workflows, trackers, or healthcare operations processes.
• Experience supporting ABA program launches or expansion.