Healthcare Credentialing Specialist - Payer & NPI

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

Benefits offered by this job

Generous paid time off

Strong benefits package

Competitive salary

Job summary

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to support provider enrollment and credentialing processes in Southeast, OH. The role emphasizes maintaining CAQH and CMS portals, updating provider data, and coordinating with payers to ensure timely credentialing.

Ideal candidates have at least 1 year in credentialing in Ohio Behavioral Health Medicaid, familiarity with EHR systems, and strong organizational and communication skills.

Qualifications

• 1 year of credentialing experience in Ohio Behavioral Health Medicaid.
• 3 years of experience using an electronic health record system to process claims.
• HS Diploma or GED required; bachelor’s preferred.

Responsibilities

• Maintain individual provider files for credentialing applications.
• Track CAQH, PECOS, NPPES, CMS portals and ensure logins are active.
• Update CAQH database files for providers on schedule.
• Complete new NPI applications for providers.
• Coordinate credentialing, re-credentialing, and contracting with payers.
• Communicate with Managed Care Organizations and CMS for credentialing steps.
• Attend trainings as needed and support the Billing Department.

Skills

Excellent communication

Excellent organizational skills

Valid driver\'s license

Auto insurance coverage

Deadline management

Internet access

EHR knowledge

Education

High school Diploma or GED

Bachelor’s degree in accounting or credentialing (preferred)

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to support provider enrollment and credentialing processes in Southeast, OH. The role emphasizes maintaining CAQH and CMS portals, updating provider data, and coordinating with payers to ensure timely credentialing.

Ideal candidates have at least 1 year in credentialing in Ohio Behavioral Health Medicaid, familiarity with EHR systems, and strong organizational and communication skills.