Delegated Credentialing QA Coordinator
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AI Summary
Delegated Credentialing QA Coordinator
Remote, Anywhere in the US
About AnswersNow:
At AnswersNow, we are trailblazing the future of autism therapy, making it more immediate, accessible, and effective for families everywhere. Our innovative virtual ABA therapy platform is thoughtfully designed by clinicians to recreate the focused, supportive environment of in-person therapy, complete with distraction-free features and interactive activities that enhance engagement and progress.
Our team operates fully remote—meaning you’ll have the flexibility to work from the comfort of home. If you're ready to make a meaningful impact and join a team that's reshaping autism therapy, we’d love to hear from you!
Why this role matters:
Ensure integrity, accuracy, and compliance of delegated credentialing processes, specifically for BCBA and related behavioral health providers. This role focuses on quality assurance, audits, and monitoring our providers documents, delegated packets to maintain adherence to regulatory, accreditation, and internal standards, ensuring continuous audit readiness. Work closely with the Senior Manager to establish, prepare and execute training materials. Collaborate with the Enrollment Submission team to manage Medicaid, MCO, and commercial payer applications to ensure stricter adherence to regulatory expectations and optimize application processing efficiency. Partner with leadership and Contracting to facilitate licensure expansion and network growth into new markets.
Job Details
W2 Employee
Full-Time
100% Remote
Job Requirements
Review BCBA and related provider packets for completeness, accuracy, and primary source verification.
Conduct routine and ad hoc audits of delegated credentialing files to ensure compliance (organizational, payer, NCQA/CMS).
Monitor delegated entities for contractual adherence (turnaround times, documentation, verification).
Maintain audit tools, checklists, and reporting dashboards.
Collaborate with the Credentialing team for policy alignment .
Support pre-delegation and annual delegation audits, including documentation.
Ensure policies reflect current regulatory/accreditation standards.
Assist with training for internal staff and delegated entities on credentialing requirements.
Participate in quality improvement and process optimization efforts
Provide comprehensive support for licensure initiatives and facilitate the expansion into new states and payer networks
What you’ll do:
Reviewing Provider Credential Packets — Examine BCBA and behavioral health provider files for completeness, accuracy, and proper primary source verification before submission or approval.
Maintaining Audit Tools & Dashboards — Build and update checklists, tracking spreadsheets, and reporting dashboards that reflect current audit findings and compliance status.
Training Development & Delivery — Work alongside the Senior Manager to create, update, and deliver training materials for internal credentialing staff and delegated entities on compliance expectations.
Contribute to Answers Now expansion into new markets by ensuring audit readiness for new state licenses and payer networks.
Monitoring Delegated Entities — Track contracted delegated entities to confirm they are meeting turnaround times, documentation standards, and verification obligations outlined in their agreements.
Policy Review & Regulatory Alignment — Regularly review internal credentialing policies to ensure they reflect the latest regulatory, accreditation, and payer-specific standards.
What we Offer
$72,000- $84,000 annual
Fully remote – work from anywhere in the U.S.
Flexible hours with an async-friendly team culture
More About AnswersNow
AnswersNow welcomes applicants of all backgrounds, experiences, and abilities. We believe a diverse team is a strong team, and are committed to provide a fair and equitable experience for every candidate. If you require reasonable accommodations at any stage, we encourage you to reach out. We’re here to support!
Learn more about us at getanswersnow.com.
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