Credentialing Specialist: Medicaid & Billing Ops

Integrated Services for Behavioral Health; Logan (OH); On-site; USD 33,000 - 39,000; 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 is seeking a Credentialing Specialist to support provider credentialing and billing operations in a Medicaid-focused environment. You will manage provider files, enrollments, and portal logins across CAQH, PECOS, NPPES, and CMS databases, ensuring timely credentialing and re-credentialing.

The role requires 1 year of credentialing experience in Ohio Medicaid, familiarity with EHR claims processing, and strong organizational skills.

Qualifications

• 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.
• Strong knowledge of community service systems and CAQH/PECOS/NPPES familiarity is expected.

Responsibilities

• Maintain provider credentialing files and up-to-date government and payer applications.
• Track CAQH, PECOS, NPPES, and CMS portals to ensure logins are active.
• Update CAQH database files for providers as per CMS schedules.
• Process new provider NPI applications and manage enrollment terminations.
• Coordinate credentialing, re-credentialing, and contracting with insurers.

Skills

Community service knowledge

EHR systems knowledge

Communication skills

Organizational skills

Driver's license

Auto insurance

Deadline management

Internet-based office

High-speed internet

Education

High school diploma or GED

Bachelor’s degree in accounting/credentialing or related field (preferred)

Tools

CAQH

PECOS

NPPES

CMS portals

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to support provider credentialing and billing operations in a Medicaid-focused environment. You will manage provider files, enrollments, and portal logins across CAQH, PECOS, NPPES, and CMS databases, ensuring timely credentialing and re-credentialing.

The role requires 1 year of credentialing experience in Ohio Medicaid, familiarity with EHR claims processing, and strong organizational skills.