Credentialing & Billing Specialist (Behavioral Health)

Integrated Services for Behavioral Health; Chillicothe (OH); On-site; USD 68,423,000 - 80,289,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Short-term Disability

Long-term Disability

401K w/ Employer Match

Employee Assistance Program (EAP)

Job summary

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing, enrollment, and related billing operations supporting Medicaid, with potential Medicare/private payer exposure. You will maintain CAQH/NPPES/PECOS records and ensure timely enrollment of providers.

The role emphasizes accuracy, coordination with insurers, and updating payer databases, in a fast-paced billing department within a community-based behavioral health setting.

Qualifications

• A high school Diploma or GED is required.
• A bachelor’s degree in accounting, credentialing, or a related field is preferred.
• 1 year of credentialing experience in Ohio Behavioral Health Medicaid is required.
• 3 years of experience using an electronic health record system to process claims is preferred.

Responsibilities

• Maintain provider files for credentialing applications and portals.
• Track CAQH, PECOS, NPPES, CMS data and login access.
• Update CAQH database files for providers on schedule.
• Enroll new providers with NPI and coordinate enrollments.
• Coordinate credentialing and re-credentialing with insurers.

Skills

Credentialing management

Communication skills

Organizational skills

Driver's license

Education

High school diploma or GED

Bachelor's degree in accounting/credentialing

Tools

CAQH

PECOS

NPPES

CMS portals

Job description

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing, enrollment, and related billing operations supporting Medicaid, with potential Medicare/private payer exposure. You will maintain CAQH/NPPES/PECOS records and ensure timely enrollment of providers.

The role emphasizes accuracy, coordination with insurers, and updating payer databases, in a fast-paced billing department within a community-based behavioral health setting.