Medicaid Credentialing & Billing Specialist

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

Job summary

Integrated Services for Behavioral Health (ISBH) is seeking a Credentialing Specialist in Ohio to manage provider credentialing, payer enrollment, and related billing support. The role emphasizes CAQH, PECOS, NPPES, and CMS portal maintenance to ensure timely credentialing for Medicaid, with potential Medicare/private payer work.

The position requires strong communication and organizational skills, a valid driver’s license, and the ability to navigate fast-paced workflows in a community-based

Qualifications

• High school diploma or GED is required.
• Bachelor’s degree in accounting or credentialing preferred.
• Minimum 1 year credentialing experience in Ohio Medicaid.

Responsibilities

• Maintain provider files and credentialing applications.
• Track CAQH, PECOS, NPPES, CMS portals and logins.
• Update CAQH files per CMS/Medicaid regulations.
• Submit NPI applications for providers.
• Terminate enrollments with payers when providers leave.
• Coordinate credentialing and re-credentialing with insurers.
• Assist Billing Department and other tasks as needed.

Skills

Communication skills

Organization

Deadline management

Internet-based office

Driver's license

Auto insurance

Education

High school Diploma or GED

Bachelor's degree in accounting, credentialing, or related field

Tools

CAQH

PECOS

NPPES

CMS databases

Job description

Integrated Services for Behavioral Health (ISBH) is seeking a Credentialing Specialist in Ohio to manage provider credentialing, payer enrollment, and related billing support. The role emphasizes CAQH, PECOS, NPPES, and CMS portal maintenance to ensure timely credentialing for Medicaid, with potential Medicare/private payer work.

The position requires strong communication and organizational skills, a valid driver’s license, and the ability to navigate fast-paced workflows in a community-based