Credentialing & Billing Specialist - Behavioral Health

Integrated Services for Behavioral Health; Cambridge (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 (ISBH) seeks a Credentialing Specialist to manage provider credentialing and related billing operations, primarily focused on Medicaid in Ohio. The role requires maintaining CAQH, PECOS, NPPES, and CMS portals, with ongoing enrollment tasks and payer follow-up.

Qualifications include a high school diploma and preferably a bachelor's in accounting or credentialing, plus 1 year credentialing experience and relevant EHR familiarity.

Qualifications

• X years of credentialing experience in Ohio Medicaid (1 year minimum).
• Experience using electronic health record systems to process claims (3 years preferred).
• Knowledge of CAQH, PECOS, NPPES, CMS portals is preferred.

Responsibilities

• Maintain provider credentialing files and government/commercial payer portals.
• Track CAQH/PECOS/NPPES/CMS statuses and keep logins active.
• Enroll providers for NPI and terminate enrollment when needed.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Communicate with managed care organizations and payers to follow up on credentialing stages.

Skills

Credentialing knowledge

Communication skills

Attention to detail

deadlines management

Education

High School Diploma or GED

Bachelor's degree in accounting or credentialing

Tools

CAQH

PECOS

NPPES

CMS portals

Job description

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing and related billing operations, primarily focused on Medicaid in Ohio. The role requires maintaining CAQH, PECOS, NPPES, and CMS portals, with ongoing enrollment tasks and payer follow-up.

Qualifications include a high school diploma and preferably a bachelor's in accounting or credentialing, plus 1 year credentialing experience and relevant EHR familiarity.