Credentialing Specialist, Behavioral Health

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

Benefits offered by this job

Generous PTO

Strong benefits package

Competitive salary

Job summary

Integrated Services for Behavioral Health is seeking a Credentialing Specialist in Southeast, OH to manage provider credentialing across CAQH, PECOS, NPPES and CMS portals. You will maintain provider profiles, coordinate enrollment, and support payer relationships to ensure timely credentialing.

Requirements include a high school diploma or GED and 1 year credentialing experience in Ohio Behavioral Health Medicaid; a bachelor’s degree is preferred.

Qualifications

• High school diploma or GED required.
• Bachelor’s degree preferred in accounting, credentialing, or related field.
• 1 year credentialing experience in Ohio Behavioral Health Medicaid required.
• 3 years experience with electronic health record systems for claims processing preferred.
• Knowledge of provider credentialing processes and payer enrollment.

Responsibilities

• Maintain provider files and credentialing applications.
• Track CAQH, PECOS, NPPES, and CMS portals and logins.
• Update CAQH provider data according to CMS regulations.
• Complete NPI applications for providers.
• Coordinate credentialing, re-credentialing, and contracting with payers.
• Follow up with managed care organizations and plans on credentialing stages.
• Attend trainings and support Billing Department as needed.

Skills

Credentialing

CAQH

CMS knowledge

Payer portals

Communication

Organizational skills

Education

High school diploma or GED

Bachelor’s degree preferred

Tools

CAQH

PECOS

NPPES

CMS databases

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist in Southeast, OH to manage provider credentialing across CAQH, PECOS, NPPES and CMS portals. You will maintain provider profiles, coordinate enrollment, and support payer relationships to ensure timely credentialing.

Requirements include a high school diploma or GED and 1 year credentialing experience in Ohio Behavioral Health Medicaid; a bachelor’s degree is preferred.