Credentialing Specialist for Medicaid & Provider Enrollment

Integratedservice; Circleville (OH); Presencial; USD 50.000 - 58.000; Jornada completa

Descripción de la vacante

Integrated Services for Behavioral Health in Southeast Ohio is seeking a Credentialing Specialist to manage provider credentialing and related billing tasks. This role focuses on Medicaid processing and ensures timely credentialing and recredentialing to support care reimbursement.

Responsibilities include maintaining provider files, CAQH/NPPES/PECOS records, enrolling with payers, and coordinating with billing teams.

Formación

• 1 year credentialing experience in Ohio Behavioral Health Medicaid.
• Experience using an electronic health record system to process claims.
• Knowledge of payer enrollment processes and credentialing timelines.

Responsabilidades

• Maintain provider files and credentialing applications.
• Track CAQH, PECOS, NPPES, and CMS portal activity.
• Update provider demographics and supporting documents.
• Enroll/terminate with payers as needed.
• Coordinate credentialing and re-credentialing with insurers.

Conocimientos

Medicaid credentialing

EHR systems knowledge

Excellent communication skills

Organizational skills

Driver's license

Internet access

Educación

High school diploma or GED

Bachelor's degree preferred

Herramientas

CAQH

PECOS

NPPES

CMS portals

Descripción del empleo

Integrated Services for Behavioral Health in Southeast Ohio is seeking a Credentialing Specialist to manage provider credentialing and related billing tasks. This role focuses on Medicaid processing and ensures timely credentialing and recredentialing to support care reimbursement.

Responsibilities include maintaining provider files, CAQH/NPPES/PECOS records, enrolling with payers, and coordinating with billing teams.