Medicaid Credentialing & Billing Specialist

Integrated Services for Behavioral Health; Lancaster (OH); On-site; USD 33,000 - 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 seeks a Credentialing Specialist to manage provider credentialing, enrollment, and related operations. The role focuses on Medicaid and may involve Medicare and private payers, ensuring timely credentialing and re-credentialing across portals.

Responsibilities include maintaining provider files, tracking CAQH/PECOS/NPPES/CMS statuses, and coordinating enrollments with insurers while supporting billing functions as needed.

Qualifications

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

Responsibilities

• Maintain provider files for credentialing applications and keep information up to date.
• Track CAQH, PECOS, NPPES, and CMS portal logins and activity.
• Update provider CAQH files per CMS/Medicaid schedules.
• Complete new provider NPI applications.
• Coordinate credentialing, re-credentialing, and enrollment with insurers.
• Support billing operations as needed to enable reimbursement.

Skills

Credentialing knowledge

Excellent communication

Organizational skills

Deadline management

Education

High school diploma or GED

Bachelor’s degree preferred

Tools

CAQH

PECOS

NPPES

CMS systems

Job description

Integrated Services for Behavioral Health seeks a Credentialing Specialist to manage provider credentialing, enrollment, and related operations. The role focuses on Medicaid and may involve Medicare and private payers, ensuring timely credentialing and re-credentialing across portals.

Responsibilities include maintaining provider files, tracking CAQH/PECOS/NPPES/CMS statuses, and coordinating enrollments with insurers while supporting billing functions as needed.