Medicaid Credentialing & Billing Specialist

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

Benefits offered by this job

Great work environment

Competitive salary

Generous PTO

Strong benefits package

Job summary

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing across Medicaid and other payers. The role includes billing support and ensuring timely credentialing and re-credentialing in CAQH, PECOS, NPPES, and CMS databases.

Candidates should have at least 1 year of credentialing in Ohio Behavioral Health Medicaid, familiarity with EHR-based claims processing, and strong communication and organizational skills.

Qualifications

• High school Diploma or GED required.
• Bachelor’s degree in accounting, credentialing, or related field preferred.
• 1 year of credentialing experience in Ohio Behavioral Health Medicaid required.
• 3 years of experience using an electronic health record system to process claims preferred.
• Broad knowledge of community service systems and CAQH/PECOS/NPPES familiarity.
• Excellent communication and organizational skills; ability to meet deadlines.

Responsibilities

• Maintain provider files and update credentialing applications with current information.
• Track CAQH, PECOS, NPPES, CMS portals’ logins and renewals for providers.
• Ensure CAQH database files are updated per CMS and payer schedules.
• Complete new provider applications for NPI numbers.
• Terminate enrollments with government and commercial payers when needed.
• Coordinate credentialing, re-credentialing, and contracting with insurers.

Skills

Excellent communication (oral &written

Excellent organizational skills

Deadline management

Internet-based, automated office work

Strong internet connectivity

Broad knowledge of community service系统

Education

High school Diploma or GED

Bachelor's degree in accounting/credentialing/related field

Tools

Electronic Health Record (EHR) systems

CAQH

PECOS

NPPES

CMS databases

Job description

Integrated Services for Behavioral Health (ISBH) seeks a Credentialing Specialist to manage provider credentialing across Medicaid and other payers. The role includes billing support and ensuring timely credentialing and re-credentialing in CAQH, PECOS, NPPES, and CMS databases.

Candidates should have at least 1 year of credentialing in Ohio Behavioral Health Medicaid, familiarity with EHR-based claims processing, and strong communication and organizational skills.