Delegated Credentialing QA Coordinator

Responsibilities

• Review BCBA and behavioral health provider files for completeness, accuracy, and primary source verification
• Conduct routine and ad hoc audits of delegated credentialing files to ensure compliance with NCQA, CMS, and payer standards
• Maintain audit tools, checklists, and reporting dashboards to track compliance status
• Monitor delegated entities for contractual adherence regarding turnaround times and documentation
• Develop and deliver training materials for internal staff and delegated entities
• Review internal credentialing policies to ensure alignment with current regulatory and accreditation standards
• Support licensure initiatives and expansion into new state markets and payer networks

Requirements

• Experience in credentialing quality assurance or auditing
• Knowledge of regulatory, accreditation, and payer-specific standards (NCQA/CMS)
• Ability to manage provider documentation and primary source verification
• Experience with audit tools and reporting dashboards

About the Company

AnswersNow is trailblazing the future of autism therapy through an innovative virtual ABA therapy platform designed to make care more immediate, accessible, and effective for families everywhere.