Medicaid Credentialing Specialist & Billing Support

Integrated Services for Behavioral Health; Belpre (OH); On-site; USD 23,000 - 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) is a community-minded behavioral health organization serving Southwestern and Central Ohio. We seek a Credentialing Specialist to manage provider credentialing, CAQH/NPPES updates, and payer enrollment, primarily focused on Medicaid.

The role involves processing credentialing applications, maintaining records, and supporting billing operations to ensure timely reimbursement in a fast-paced environment.

Qualifications

• High school diploma or GED required.
• Bachelor’s degree in accounting, credentialing, or related field preferred.
• 1 year credentialing experience in Ohio Behavioral Health Medicaid required.
• 3 years experience using an electronic health record system to process claims preferred.

Responsibilities

• Maintain provider files with up-to-date information for credentialing applications.
• Track CAQH, PECOS, NPPES, CMS portals to ensure active logins.
• Update CAQH database files for providers according to CMS/Medicare/Medicaid schedules.
• Complete new provider NPI applications.
• Terminate enrollments with government and commercial payers when needed.
• Coordinate and maintain credentialing, re-credentialing, and contracting with insurers.

Skills

Communication

Organizational skills

Driver's license

Auto insurance

Internet access

Education

High school diploma or GED

Bachelor’s degree preferred in accounting/credentialing

Tools

CAQH

PECOS

NPPES

CMS portals

Job description

Integrated Services for Behavioral Health (ISBH) is a community-minded behavioral health organization serving Southwestern and Central Ohio. We seek a Credentialing Specialist to manage provider credentialing, CAQH/NPPES updates, and payer enrollment, primarily focused on Medicaid.

The role involves processing credentialing applications, maintaining records, and supporting billing operations to ensure timely reimbursement in a fast-paced environment.