Credentialing & Billing Specialist (Medicaid Focus)

Integrated Services for Behavioral Health; Hillsboro (OH); Presencial; USD 33.000 - 39.000; Jornada completa

Descripción de la vacante

Integrated Services for Behavioral Health (ISBH) in Ohio is seeking a Credentialing Specialist to manage provider credentialing and related billing operations. The role centers on Medicaid enrollment and maintaining payer portals.

You will maintain CAQH, PECOS, NPPES, enroll providers with CMS Medicaid and commercial plans, and coordinate credentialing and re-credentialing to ensure timely reimbursement. Strong knowledge of payer requirements and excellent communication are essential.

Formación

• 1 year of credentialing experience in Ohio Behavioral Health Medicaid.
• 3 years of experience using an electronic health record system to process claims.

Responsabilidades

• Maintain provider credentialing files with up-to-date information for payer applications.
• Track CAQH, PECOS, NPPES, and CMS enrollment portals and ensure logins are active.
• Update CAQH files for providers as CMS and regulators require.
• Complete NPI applications for new providers.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Follow up with payers on credentialing status and issues.

Conocimientos

Credentialing

Medicaid knowledge

EHR proficiency

Communication

Time management

Driver's license

Educación

High school diploma or GED

Bachelor’s degree preferred in accounting/credentialing

Herramientas

CAQH

PECOS

NPPES

CMS databases

Descripción del empleo

Integrated Services for Behavioral Health (ISBH) in Ohio is seeking a Credentialing Specialist to manage provider credentialing and related billing operations. The role centers on Medicaid enrollment and maintaining payer portals.

You will maintain CAQH, PECOS, NPPES, enroll providers with CMS Medicaid and commercial plans, and coordinate credentialing and re-credentialing to ensure timely reimbursement. Strong knowledge of payer requirements and excellent communication are essential.