Medicaid Credentialing Specialist | Billing & Payer Support

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

Job summary

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to manage provider credentialing processes, update CAQH/NPPES/PECOS profiles, and coordinate payer enrollments in Medicaid-focused operations in Ohio.

The role supports provider enrollment, re-credentialing, and contracting with payers while ensuring timely credentialing and updates to demographic information. A high school diploma is required, with a bachelor’s degree preferred.

Qualifications

• 1 year of credentialing experience in Ohio Behavioral Health Medicaid.
• Experience using an electronic health record (EHR) system to process claims (3 years preferred).
• High school diploma or GED required; bachelor’s degree preferred.

Responsibilities

• Maintain provider credentialing files and portal logins (CAQH, PECOS, NPPES, CMS).
• Update provider CAQH profiles per CMS/Medicaid schedules.
• Process NPI applications and manage enrollment with payers.
• Coordinate credentialing and re-credentialing with insurers and providers.

Skills

Knowledge of Medicaid credentialing

Communication skills

Organizational skills

Driver's license

Education

High school Diploma or GED

Bachelor's degree in accounting/credentialing/related field

Tools

CAQH

PECOS

NPPES

CMS portals

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to manage provider credentialing processes, update CAQH/NPPES/PECOS profiles, and coordinate payer enrollments in Medicaid-focused operations in Ohio.

The role supports provider enrollment, re-credentialing, and contracting with payers while ensuring timely credentialing and updates to demographic information. A high school diploma is required, with a bachelor’s degree preferred.