Medicaid Credentialing Specialist

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

Job summary

Integrated Services for Behavioral Health is seeking a Credentialing Specialist in Southeast, OH to manage provider credentialing and related billing operations. The role focuses on Medicaid credentialing with potential work with Medicare and private payers.

The position requires 1 year of credentialing experience in Ohio Medicaid and familiarity with EHR systems for claims processing. Strong organizational skills and attention to detail are essential for success.

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 to complete credentialing applications.
• Track CAQH, PECOS, NPPES, and CMS portals for active logins.
• Update CAQH provider files per CMS schedules.
• Prepare NPI applications for providers.
• Coordinate credentialing and re-credentialing with insurers.
• Assist with client billing and reimbursement processes.
• Attend trainings as needed.

Skills

Excellent communication

Organizational skills

Time management

Driver's license

Internet proficiency

Credentialing knowledge

Education

High school diploma or GED

Bachelor's degree (preferred)

Tools

EHR systems

CAQH

PECOS

NPPES

CMS portals

Billing software

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist in Southeast, OH to manage provider credentialing and related billing operations. The role focuses on Medicaid credentialing with potential work with Medicare and private payers.

The position requires 1 year of credentialing experience in Ohio Medicaid and familiarity with EHR systems for claims processing. Strong organizational skills and attention to detail are essential for success.