Medicaid Credentialing Specialist | EHR & Billing Support

Integrated Services for Behavioral Health; Circleville (OH); On-site; USD 33,000 - 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 in Circleville, OH is seeking a Credentialing Specialist to manage provider credentialing and related billing operations. The role focuses on Medicaid, with potential work across Medicare and private payers, supporting timely credentialing and reimbursement.

Responsibilities include maintaining provider profiles in CAQH/PECOS/NPPES, enrolling providers, and coordinating credentialing with payer networks.

Qualifications

• 1 year credentialing experience in Ohio Behavioral Health Medicaid is required.
• Familiarity with CAQH, PECOS, NPPES, and CMS portals preferred.
• Strong organizational and communication skills are essential.

Responsibilities

• Maintain provider files with up-to-date credentialing information.
• Track and manage CAQH, PECOS, NPPES, and CMS portal logins.
• Complete NPI applications and manage provider enrollment.
• Coordinate credentialing with insurance providers and payers.
• Support billing processes to aid timely reimbursements.

Skills

Credentialing

Medicaid knowledge

CAQH

Documentation

Communication

Education

High School Diploma

Bachelor's degree preferred

Tools

EHR system

PECOS

NPPES

Job description

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

Responsibilities include maintaining provider profiles in CAQH/PECOS/NPPES, enrolling providers, and coordinating credentialing with payer networks.