Medicaid Credentialing Specialist - Behavioral Health

Integratedservice

McArthur Township (OH)

On-site

USD 33,000 - 39,000

Full time

14 days+

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Job summary

Integrated Services for Behavioral Health (ISBH) in Southeast, OH is seeking a Credentialing Specialist. The role focuses on Medicaid credentialing and related payer enrollment, with some client billing responsibilities to support reimbursement for behavioral health services.

You will maintain provider files, manage CAQH/NPPES/PECOS portals, enroll new providers, and coordinate credentialing across payers. A high school diploma is required; a bachelor's degree is preferred, and 1 year

Qualifications

1 year of credentialing experience in Ohio Behavioral Health Medicaid is required.
Bachelor's degree preferred in accounting, credentialing, or related field.
Experience with electronic health record systems for processing claims is preferred.

Responsibilities

Maintain provider files with up-to-date information for credentialing applications.
Track CAQH, PECOS, NPPES, and CMS portals; ensure logins are active.
Update CAQH database files for providers according to CMS/Medicaid regulations.
Complete new provider applications for NPI numbers.
Terminate enrollments with government and commercial payers when needed.
Coordinate credentialing and re-credentialing with insurance companies.
Follow up with payer organizations on credentialing stages.
Attend trainings as needed and support IS Billing Department.