Credentialing & Billing Specialist (Medicaid)

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

Job summary

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing applications and enrollment activities, primarily for Medicaid, in Southeast Ohio. This role also supports billing processes to secure reimbursement for behavioral health services.

You will maintain CAQH/PECOS/NPPES records, process NPI applications, and coordinate with insurers to ensure enrollments remain active. A HS diploma is required; a Bachelor's is preferred.

Qualifications

• 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 credentialing files and portals (CAQH, PECOS, NPPES, CMS).
• Update CAQH provider profiles per CMS schedules.
• Complete NPI applications for providers.
• Terminate enrollments with government/commercial payers when needed.
• Coordinate credentialing and re-credentialing with insurers.
• Assist with billing-related tasks to support reimbursement.

Skills

Communication

Organization

Driver's license

Auto insurance

Deadline management

Internet tools

Education

High school diploma or GED

Bachelor’s degree in accounting, credentialing, or related field (preferred)

Tools

CAQH

PECOS

NPPES

CMS databases

Job description

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing applications and enrollment activities, primarily for Medicaid, in Southeast Ohio. This role also supports billing processes to secure reimbursement for behavioral health services.

You will maintain CAQH/PECOS/NPPES records, process NPI applications, and coordinate with insurers to ensure enrollments remain active. A HS diploma is required; a Bachelor's is preferred.