Behavioral Health Credentialing Specialist — Medicaid Focus

Integrated Services for Behavioral Health; Middleport (OH); On-site; USD 33,000 - 39,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Short-term Disability

Long-term Disability

401K w/ Employer Match

EAP

Job summary

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to manage provider credentialing and related billing processes in southeast Ohio. The role centers on Medicaid and may involve CMS and payer interactions to ensure timely enrollment and recredentialing.

The candidate will maintain CAQH/NPPES/PECOS records, coordinate portal access, and support reimbursement activities. A high school diploma is required; a bachelor''s degree is preferred, with at least one year in

Qualifications

• 1 year credentialing experience in Ohio Behavioral Health Medicaid.
• 3 years of EHR claims processing experience preferred.
• Knowledge of CAQH, PECOS, NPPES, CMS databases.
• Excellent oral and written communication skills.
• Valid driver''s license and ability to drive.
• Auto insurance coverage as required.

Responsibilities

• Maintain provider files to support credentialing applications.
• Track logins for payer portals and ensure access.
• Update CAQH files per CMS/Medicare schedules.
• Complete NPI applications.
• Terminate enrollments with payers when providers resign.
• Provide updated demographics to outside participants.
• Maintain provider profiles on CAQH/NPPES/CMS.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Follow up with payers on credentialing stages.
• Attend trainings as needed.
• Support IS Billing Department as required.

Skills

Credentialing

Medicaid

Communication

Organizational skills

Driver's license

Auto insurance

Education

High school diploma

Bachelor's degree preferred

Tools

CAQH

PECOS

NPPES

CMS portals

EHR systems

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to manage provider credentialing and related billing processes in southeast Ohio. The role centers on Medicaid and may involve CMS and payer interactions to ensure timely enrollment and recredentialing.

The candidate will maintain CAQH/NPPES/PECOS records, coordinate portal access, and support reimbursement activities. A high school diploma is required; a bachelor''s degree is preferred, with at least one year in