Medicaid Credentialing & Billing Specialist

Integrated Services for Behavioral Health; Athens (OH); On-site; USD 32,000 - 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 (ISBH) seeks a Credentialing Specialist to manage provider credentialing and related billing operations in southeastern Ohio. This role focuses primarily on Medicaid enrollment, with potential interaction with Medicare and private payers.

The successful candidate will maintain provider files, ensure CAQH/NPPES/PECOS accuracy, and support timely credentialing and recredentialing. ISBH offers a collaborative environment and benefits package.

Qualifications

• High school diploma or GED required.
• Bachelor’s degree in accounting, credentialing, or related field preferred.
• 1 year of credentialing experience in Ohio Behavioral Health Medicaid required.
• 3 years of experience using an EHR system to process claims preferred.

Responsibilities

• Maintain individual provider files and required portal credentials (CAQH, PECOS, NPPES, CMS).
• Track enrollments with managed care organizations, CMS, Medicaid, and commercial payers.
• Update CAQH and NPPES data per CMS schedules.
• Complete NPI provider applications and terminate enrollments as needed.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Communicate with MCOs, CMS, and payers to advance stages in credentialing.
• Attend trainings and support billing department operations.

Skills

Community services knowledge

Electronic health records

Excellent communication

Organizational skills

Driver's license

Auto insurance

Deadline management

Internet-based work

Education

High school Diploma or GED

Bachelor’s degree (preferred)

Job description

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing and related billing operations in southeastern Ohio. This role focuses primarily on Medicaid enrollment, with potential interaction with Medicare and private payers.

The successful candidate will maintain provider files, ensure CAQH/NPPES/PECOS accuracy, and support timely credentialing and recredentialing. ISBH offers a collaborative environment and benefits package.