Credentialing Specialist: Behavioral Health & Billing

Integratedservice; Athens (OH); Sur place; USD 33 000 - 39 000; Plein temps

Résumé du poste

Integrated Services for Behavioral Health in Southeast Ohio is seeking a Credentialing Specialist to manage provider credentialing and related billing operations. The role focuses on Medicaid enrollment, CAQH, PECOS, NPPES, and CMS processes, ensuring timely credentialing and re-credentialing across multiple payers.

The position requires strong organizational and communication skills, with familiarity in EHR systems and payer enrollment workflows.

Qualifications

• High school Diploma or GED is required.
• Bachelor’s degree in accounting, credentialing, or related field is preferred.
• 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.

Responsabilités

• Maintain individual provider files for government and commercial payer credentialing applications.
• Track portal logins for CAQH, PECOS, NPPES, CMS; ensure active access.
• Update CAQH files for providers in line with CMS and payer schedules.
• Complete new provider NPI applications.
• Terminate enrollments with government and commercial payers when needed.
• Maintain provider profiles on CAQH, PECOS, NPPES, CMS databases.
• Coordinate credentialing, re-credentialing, and contracting with insurers.

Connaissances

Communication skills

Organizational skills

Deadline management

Internet-based office tools

Formation

High school Diploma or GED

Bachelor’s degree preferred

Outils

Electronic Health Record (EHR) systems

Description du poste

Integrated Services for Behavioral Health in Southeast Ohio is seeking a Credentialing Specialist to manage provider credentialing and related billing operations. The role focuses on Medicaid enrollment, CAQH, PECOS, NPPES, and CMS processes, ensuring timely credentialing and re-credentialing across multiple payers.

The position requires strong organizational and communication skills, with familiarity in EHR systems and payer enrollment workflows.