Medicaid Credentialing & Billing Specialist

Integrated Services for Behavioral Health; Marietta (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 is seeking a Credentialing Specialist in Southeast, OH. The role focuses on Medicaid credentialing and supporting related billing activities to enable reimbursement for behavioral health services.

You will maintain provider files, manage CAQH/NPPES/PECOS portals, and coordinate enrollment with government and private payers. A high school diploma is required; a Bachelor’s degree is preferred, with 1 year of credentialing experience in Ohio Medicaid.

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 using an electronic health record system to process claims preferred.

Responsibilities

• Maintain provider files for credentialing applications.
• Track CAQH, PECOS, NPPES, CMS portals for active logins.
• Update CAQH database files on schedule per CMS regulations.
• Prepare National Provider Identifier (NPI) applications.
• Terminate enrollments when providers resign or are terminated.
• Provide updated demographic information to payers and billing entities.
• Maintain provider profiles in CAQH, PECOS, NPPES, CMS databases.
• Ensure credentialing/re-credentialing is timely.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Contact payers to follow up on credentialing stages.
• Identify onboarding issues and assist with resolution.
• Attend trainings and support Billing Department.

Skills

Communication

Organizational skills

Driver's license

Internet-based office environment

Team collaboration

Customer service

Education

High school diploma or GED

Bachelor’s degree in accounting/credentialing or related field

Tools

EHR systems

CAQH / PECOS / NPPES portals

CMS credentialing processes

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist in Southeast, OH. The role focuses on Medicaid credentialing and supporting related billing activities to enable reimbursement for behavioral health services.

You will maintain provider files, manage CAQH/NPPES/PECOS portals, and coordinate enrollment with government and private payers. A high school diploma is required; a Bachelor’s degree is preferred, with 1 year of credentialing experience in Ohio Medicaid.