Medicaid Credentialing & Billing Specialist

Integratedservice; Circleville (OH); On-site; USD 3,286,000 - 3,860,000; Full time

Job summary

Integrated Services for Behavioral Health (ISBH) in Ohio is seeking a Credentialing Specialist to manage provider credentialing and related billing operations. The role focuses on Medicaid and may involve Medicare or private payers.

It requires accuracy, communication, and strong organizational skills. The successful candidate will maintain provider files, oversee CAQH/NPPES/PECOS CMS portals, enroll and terminate enrollments, and support the Billing Department with timely credentialing

Qualifications

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

Responsibilities

• Maintain provider files for government and commercial credentialing.
• Track CAQH, PECOS, NPPES, CMS portals and ensure logins active.
• Update CAQH files per CMS, Medicare/Medicaid, and payer regulations.
• Enroll/terminate providers with government and commercial payers.
• Coordinate credentialing, re-credentialing and contracting with insurers.

Skills

Communication skills

Organizational skills

Time management

Driver's license

Internet access

Education

High school diploma

Bachelor's degree preferred

Tools

CAQH

PECOS

CMS portals

NPPES

Job description

Integrated Services for Behavioral Health (ISBH) in Ohio is seeking a Credentialing Specialist to manage provider credentialing and related billing operations. The role focuses on Medicaid and may involve Medicare or private payers.

It requires accuracy, communication, and strong organizational skills. The successful candidate will maintain provider files, oversee CAQH/NPPES/PECOS CMS portals, enroll and terminate enrollments, and support the Billing Department with timely credentialing