Credentialing Specialist: Medicaid & Billing Support

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

Job summary

Integrated Services for Behavioral Health in Southeast Ohio seeks a Credentialing Specialist to manage provider credentialing and related billing operations. The role emphasizes Medicaid, with potential Medicare and private payer work.

Experience with CAQH, PECOS, NPPES, and CMS databases is valuable. The position requires a high school diploma or GED; a bachelor’s degree in accounting or credentialing is preferred.

Qualifications

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

Responsibilities

• Maintain provider credentialing files and enrollment with government and commercial payers.
• Manage CAQH, PECOS, NPPES, CMS portal logins and required credentials.
• Update NPI applications and terminate enrollments as needed.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Communicate with managed care organizations and plans to advance credentialing stages.

Skills

Credentialing

CAQH

NPPES

CMS

Communication

Organization

Driver's license

Internet

Education

High school diploma or GED

Bachelor's degree preferred

Tools

Electronic Health Record system

CAQH portal

Job description

Integrated Services for Behavioral Health in Southeast Ohio seeks a Credentialing Specialist to manage provider credentialing and related billing operations. The role emphasizes Medicaid, with potential Medicare and private payer work.

Experience with CAQH, PECOS, NPPES, and CMS databases is valuable. The position requires a high school diploma or GED; a bachelor’s degree in accounting or credentialing is preferred.