Credentialing & Billing Specialist - Medicaid Focus

Integrated Services for Behavioral Health; Gallipolis (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

Employee Assistance Program (EAP)

Job summary

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to support Medicaid credentialing with occasional Medicare and private payers. The role focuses on maintaining CAQH, PECOS, NPPES, and CMS portals, enrolling providers, and ensuring timely credentialing and re-credentialing.

Strong attention to detail and communication skills are essential. Qualifications include a high school diploma, a preferred bachelor’s in accounting or credentialing, and experience with EHR

Qualifications

• High school diploma required; a bachelor’s in accounting or credentialing preferred.
• 1 year credentialing experience in Ohio Behavioral Health Medicaid required.
• Experience with CAQH, PECOS, NPPES, and CMS portals is preferred.

Responsibilities

• Maintain provider credentialing files and government/commercial payer applications.
• Track CAQH, PECOS, NPPES, and CMS portal logins and activity.
• Coordinate, monitor, and maintain credentialing and re-credentialing with insurers.
• Update NPI applications and terminate enrollments when needed.
• Support the Billing Department with tasks related to reimbursement.

Skills

Credentialing experience

Communication skills

Organizational skills

Deadline management

Driver's license

Education

High school Diploma or GED

Bachelor’s degree in accounting/credentialing

Tools

CAQH

PECOS

NPPES

CMS portals

Electronic Health Record (EHR) system

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to support Medicaid credentialing with occasional Medicare and private payers. The role focuses on maintaining CAQH, PECOS, NPPES, and CMS portals, enrolling providers, and ensuring timely credentialing and re-credentialing.

Strong attention to detail and communication skills are essential. Qualifications include a high school diploma, a preferred bachelor’s in accounting or credentialing, and experience with EHR