Credentialing Specialist - Behavioral Health Payer

Integrated Services for Behavioral Health; Coshocton (OH); On-site; USD 50,000 - 58,000; 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 (ISBH) in Southeast Ohio is seeking a Credentialing Specialist to manage provider credentialing with Medicaid and other payers. You will maintain provider files, track CAQH/PECOS/NPPES, and ensure timely updates and enrollments.

You will coordinate with insurers, complete NPI applications, and support the Billing Department to maintain accurate credentialing and recredentialing records, while complying with applicable regulations.

Qualifications

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

Responsibilities

• Maintain provider files and credentialing applications.
• Track CAQH/PECOS/NPPES and portal logins.
• Update CAQH, PECOS, NPPES, and CMS database files.
• Complete NPI applications for providers.
• Terminate enrollments with payers when needed.
• Provide updated demographics to external participants.
• Coordinate credentialing and re-credentialing with insurers.
• Follow up with MCOs, CMS, and commercial plans on credentialing stages.
• Identify onboarding issues and facilitate resolutions.
• Attend trainings and support Billing Department.

Skills

Excellent communication

Excellent organizational

Deadline management

Driver's license

Internet access

EHR knowledge

Community services knowledge

Education

High school diploma or GED

Bachelor's degree preferred

Job description

Integrated Services for Behavioral Health (ISBH) in Southeast Ohio is seeking a Credentialing Specialist to manage provider credentialing with Medicaid and other payers. You will maintain provider files, track CAQH/PECOS/NPPES, and ensure timely updates and enrollments.

You will coordinate with insurers, complete NPI applications, and support the Billing Department to maintain accurate credentialing and recredentialing records, while complying with applicable regulations.