Behavioral Health Medicaid Credentialing Specialist

Integratedservice; Belpre (OH); On-site; USD 33,000 - 39,000; Full time

Benefits offered by this job

Generous paid time off

Strong benefits package

Excellent salary

Job summary

Integrated Services for Behavioral Health (ISBH) is seeking a Credentialing Specialist to support provider enrollment and credentialing processes with Medicaid focus in Southeast Ohio. The role involves maintaining CAQH, PECOS, NPPES, and CMS portal data, and coordinating enrollments with insurers.

Strong attention to detail and timelines are essential. The position may also assist with client billing activities to ensure proper reimbursement for behavioral health services.

Qualifications

• 1 year of credentialing experience in Ohio Behavioral Health Medicaid.
• Experience with EHR systems for claims processing is preferred (3 years).

Responsibilities

• Maintain provider credentialing files and portals (CAQH, PECOS, NPPES, CMS).
• Ensure CAQH data is up-to-date and provider enrollment for NPI is completed.
• Terminate enrollments when providers resign or leave.
• Coordinate credentialing and re-credentialing with insurers.
• Assist with billing operations to support reimbursement.

Skills

Credentialing

Medicaid knowledge

EHR systems

Communication

Organization

Driver's license

Education

High school diploma or GED

Bachelor’s degree in accounting/credentialing or related field

Tools

CAQH

PECOS

NPPES

CMS portals

Job description

Integrated Services for Behavioral Health (ISBH) is seeking a Credentialing Specialist to support provider enrollment and credentialing processes with Medicaid focus in Southeast Ohio. The role involves maintaining CAQH, PECOS, NPPES, and CMS portal data, and coordinating enrollments with insurers.

Strong attention to detail and timelines are essential. The position may also assist with client billing activities to ensure proper reimbursement for behavioral health services.