Medicaid Credentialing & Billing Specialist

Integrated Services for Behavioral Health; McConnelsville (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 (ISBH) seeks a Credentialing Specialist to manage provider credentialing and billing operations, primarily for Medicaid, with potential Medicare and private payers. The role supports ISBH across Southeast Ohio communities, meeting people where they are and helping them access care.

You will maintain provider files, track CAQH/PECOS/NPPES/CMS portals, process NPI enrollments, handle enrollments termination, and coordinate credentialing with insurers,

Qualifications

• 1 year of credentialing experience in Ohio Behavioral Health Medicaid.
• 3 years of experience using an electronic health record system to process claims.

Responsibilities

• Maintain provider files for credentialing applications.
• Track CAQH, PECOS, NPPES, CMS portals and logins.
• Update CAQH files per CMS/Medicare/Medicaid schedules.
• Complete NPI applications for providers.
• Terminate enrollments with payers when providers resign.
• Provide updated demographics to external parties with docs.
• Maintain provider profiles on CAQH, PECOS, NPPES, CMS.
• Ensure provider information is current for credentialing and recredentialing.
• Coordinate credentialing, re-credentialing, and contracting with insurers.
• Contact payers to follow up on credentialing stages.
• Identify onboarding issues and resolve.
• Attend trainings as needed.
• Support Integrated Services Billing Department.

Skills

Communication skills

Organizational skills

EHR knowledge

Internet literacy

Driver's license

Education

High school diploma or GED

Bachelor’s degree in accounting or related field

Job description

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing and billing operations, primarily for Medicaid, with potential Medicare and private payers. The role supports ISBH across Southeast Ohio communities, meeting people where they are and helping them access care.

You will maintain provider files, track CAQH/PECOS/NPPES/CMS portals, process NPI enrollments, handle enrollments termination, and coordinate credentialing with insurers,