Medicaid Credentialing Specialist: Payer Access

Integrated Services for Behavioral Health; Middleport (OH); Vor Ort; USD 33.000 - 39.000; Vollzeit

Benefits dieser Stelle

Medical

Dental

Vision

Short-term Disability

Long-term Disability

401K w/ Employer Match

Employee Assistance Program (EAP)

Zusammenfassung

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to manage provider credentialing files and payer enrollments. The role focuses on Medicaid coordination, CAQH updates, and timely enrollment with CMS and commercial plans.

The position also supports client billing activities and works closely with the Billing Department to ensure accurate reimbursements and ongoing compliance in a fast-paced environment.

Qualifikationen

• Credentialing knowledge of government and commercial payer processes.
• Experience with CAQH, PECOS, NPPES, and CMS databases is preferred.
• Ability to manage enrollment and re-credentialing timely.

Aufgaben

• Maintain provider credentialing files and required payer portals.
• Track CAQH/PECOS/NPPES/CMS enrollments and ensure active logins.
• Complete NPI applications for new providers and terminate enrollments as needed.
• Coordinate credentialing, re-credentialing, and contracting with insurers.

Kenntnisse

Credentialing

CAQH

NPI enrollment

Medicaid knowledge

Communication skills

Ausbildung

High school diploma

Bachelor’s degree in accounting/credentialing/related field

Tools

Electronic Health Record (EHR) systems

Jobbeschreibung

Integrated Services for Behavioral Health is seeking a Credentialing Specialist to manage provider credentialing files and payer enrollments. The role focuses on Medicaid coordination, CAQH updates, and timely enrollment with CMS and commercial plans.

The position also supports client billing activities and works closely with the Billing Department to ensure accurate reimbursements and ongoing compliance in a fast-paced environment.