Credentialing & Billing Specialist – Behavioral Health

Integrated Services for Behavioral Health; Jackson (OH); On-site; USD 68,340,000 - 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 is seeking a Credentialing Specialist to manage provider credentialing with Medicaid focus and payer enrollment. The role involves CAQH, PECOS, NPPES, CMS portal tracking and ensuring timely recredentialing.

Primary duties include maintaining provider files, coordinating with insurers, and supporting billing operations to maximize reimbursement for behavioral health services.

Qualifications

• High school diploma or GED required.
• Bachelor's degree in accounting, credentialing, or related field preferred.

Responsibilities

• Maintain individual provider files with up-to-date information for credentialing and payer applications.
• Manage CAQH, PECOS, NPPES, and CMS portal logins and tracking.
• Update CAQH files with CMS/Medicare/Medicaid timelines.
• Complete NPI credentialing applications.
• Terminate enrollments when providers resign or are terminated.
• Provide updated demographic information to outside participants as needed.
• Maintain provider profiles on CAQH, PECOS, NPPES, and CMS databases.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Follow up with Managed Care Organizations and payers on credentialing stages.
• Identify onboarding issues and facilitate resolutions.
• Attend trainings as needed.
• Support ISBH Billing Department.

Skills

Communication

Organizational skills

Time management

Attention to detail

Education

High school Diploma or GED

Bachelor's degree in accounting, credentialing, or related field

Tools

EHR systems

CAQH

PECOS

NPPES

CMS portals

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to manage provider credentialing with Medicaid focus and payer enrollment. The role involves CAQH, PECOS, NPPES, CMS portal tracking and ensuring timely recredentialing.

Primary duties include maintaining provider files, coordinating with insurers, and supporting billing operations to maximize reimbursement for behavioral health services.