Credentialing & Billing Specialist, Behavioral Health

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

Job summary

Integrated Services for Behavioral Health in Southeast Ohio seeks a Credentialing Specialist to manage provider credentialing across Medicaid and related payers. The role includes CAQH/PECOS/NPPES tracking, NPI applications, and enrollment terminations.

Responsibilities cover maintaining provider profiles, coordinating credentialing processes, and supporting billing operations to ensure reimbursement for behavioral health services. Strong communication and organizational skills are essential.

Qualifications

• High school Diploma or GED required.
• Bachelor’s degree in accounting, credentialing, or related field preferred.
• 1 year credentialing experience in Ohio Behavioral Health Medicaid required.
• 3 years experience using an EHR to process claims preferred.

Responsibilities

• Maintain provider files with required info for credentialing applications.
• Track logins for payer portals (CAQH, PECOS, NPPES, CMS).
• Update CAQH/NPPES/PECOS/CMS provider profiles as needed.
• Submit NPI applications for new providers.
• Terminate enrollments with government and commercial payers when needed.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Communicate with Managed Care Organizations and billing entities to resolve issues.
• Attend trainings and support IS billing department.

Skills

Communication skills

Organizational skills

Driver's license

Internet-based office tools

Education

High school diploma or GED

Bachelor’s degree preferred (accounting/credentialing)

Tools

CAQH

PECOS

NPPES

CMS databases

Electronic health record systems

Job description

Integrated Services for Behavioral Health in Southeast Ohio seeks a Credentialing Specialist to manage provider credentialing across Medicaid and related payers. The role includes CAQH/PECOS/NPPES tracking, NPI applications, and enrollment terminations.

Responsibilities cover maintaining provider profiles, coordinating credentialing processes, and supporting billing operations to ensure reimbursement for behavioral health services. Strong communication and organizational skills are essential.