Medicaid Credentialing & Billing Specialist

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

Job summary

Integrated Services for Behavioral Health in Ohio is seeking a Credentialing Specialist to manage provider credentialing and related client billing activities. The role focuses on Medicaid, with potential work with Medicare and private payers, and supports the Billing Department in reimbursement efforts.

Responsibilities include maintaining provider files, CAQH/PECOS/NPPES/CMS databases, updating NPI applications, and coordinating credentialing across plans.

Qualifications

• High school diploma or GED required.
• Bachelor’s degree in accounting, credentialing, or related field preferred.
• 1 year credentialing experience in Ohio Behavioral Health Medicaid required.
• 3 years of experience with electronic health record systems preferred.
• Excellent communication and organizational skills.

Responsibilities

• Maintain provider credentialing files and logins for portals.
• Track CAQH, PECOS, NPPES, and CMS databases for credentialing.
• Update CAQH files and submit NPI applications as needed.
• Coordinate credentialing and re-credentialing with plans and providers.
• Assist with related billing tasks to support reimbursement.

Skills

Excellent communication

Excellent organizational

Driver's license

Deadline management

Internet-based office

Education

High school Diploma or GED

Bachelor’s degree in accounting or credentialing

Tools

CAQH

PECOS

NPPES

CMS databases

EHR systems

Job description

Integrated Services for Behavioral Health in Ohio is seeking a Credentialing Specialist to manage provider credentialing and related client billing activities. The role focuses on Medicaid, with potential work with Medicare and private payers, and supports the Billing Department in reimbursement efforts.

Responsibilities include maintaining provider files, CAQH/PECOS/NPPES/CMS databases, updating NPI applications, and coordinating credentialing across plans.