Koala ABA & Learning Centers provides multidisciplinary care for children with autism and developmental differences. The Insurance Authorization & Credentialing Specialist supports the organization by managing insurance authorizations, reauthorizations, provider credentialing, enrollment, and payer requirements to help prevent delays in care and interruptions in services.
This role works closely with Clinical Services, Intake, Care Management, Scheduling, Billing, and Human Resources to ensure clients can start and continue services and that clinicians are properly credentialed to provide and bill for care.
Key responsibilities include tracking authorizations and expirations, submitting and following up on payer requests, coordinating required documentation, maintaining credentialing files, monitoring provider eligibility, and supporting audits and payer communications. The position also helps resolve authorization and credentialing issues that may affect client care, scheduling, or reimbursement.
The job is based in person in Miami, Florida and offers full-time hours at 40 hours per week.
High school diploma or equivalent required; associate or bachelor's degree preferred.
Minimum of 2 years of experience in healthcare authorization, credentialing, insurance verification, medical billing, or a related healthcare administrative function.
Experience working with Medicaid and/or commercial insurance plans.
Strong understanding of insurance authorization and credentialing processes.
Excellent organizational skills and ability to manage multiple deadlines simultaneously.
Strong attention to detail and follow-through.
Excellent written and verbal communication skills.
Proficiency with Microsoft Office, Excel, payer portals, and electronic health record systems.
Ability to work collaboratively across multiple departments while maintaining accountability for assigned responsibilities.
Preferred experience includes ABA, behavioral health, pediatric therapy, Florida Medicaid credentialing and authorization, credentialing BCBAs, BCaBAs, and RBTs, CAQH, commercial payer portals, CentralReach or similar ABA practice management systems, and bilingual English/Spanish skills.
Dental insurance
Health insurance
Paid time off
Location
Miami, Florida, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago