Credentialing & Billing Specialist — Behavioral Health

Integratedservice; Belpre (OH); On-site; USD 68,340,000 - 80,289,000; Full time

Job summary

Integrated Services for Behavioral Health in Ohio is hiring a Credentialing Specialist to manage provider credentialing, enrollments, and payer communications. The role emphasizes Medicaid credentialing, with possible Medicare and private payer work, and requires attention to detail and strong communication skills.

The position supports the Billing Department and involves CAQH/PECOS/NPPES updates, NPI applications, and timely credentialing activities to ensure reimbursements and compliance.

Qualifications

• High school diploma or GED required; bachelor's preferred in accounting/credentialing or related field.
• 1 year credentialing experience in Ohio Behavioral Health Medicaid required; 3 years EHR claims experience preferred.
• Knowledge of CAQH, PECOS, NPPES, CMS databases and portals; strong organizational skills.

Responsibilities

• Maintain provider files with up-to-date credentialing information for governmental and commercial payer applications.
• Manage CAQH, PECOS, NPPES, CMS portal tracking and ensure logins are active.
• Update CAQH/NPPES/PECOS files as required by CMS and payers’ schedules.
• Complete NPI applications for individual providers and manage enrollments with payers.
• Coordinate with providers on enrollment changes and with billing entities as needed.
• Maintain provider profiles to support timely credentialing and recredentialing.

Skills

Communication skills

Organizational skills

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 in Ohio is hiring a Credentialing Specialist to manage provider credentialing, enrollments, and payer communications. The role emphasizes Medicaid credentialing, with possible Medicare and private payer work, and requires attention to detail and strong communication skills.

The position supports the Billing Department and involves CAQH/PECOS/NPPES updates, NPI applications, and timely credentialing activities to ensure reimbursements and compliance.