Medicaid Credentialing Specialist & Payer Ops

Integrated Services for Behavioral Health; Newark (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 is seeking a Credentialing Specialist in Southeast Ohio. The role manages provider credentialing processes and helps with client billing and reimbursement workflows across Medicaid, with potential Medicare or private payer work.

The position emphasizes updating CAQH, PECOS, NPPES, and CMS databases, coordinating enrollment and recredentialing, and ensuring timely credentialing for providers. Excellent organizational skills are essential.

Qualifications

• High school diploma or GED required; bachelor’s degree preferred in accounting, credentialing, or related field.
• 1 year of credentialing experience in Ohio Behavioral Health Medicaid is required; 3 years in processing claims via an EHR is preferred.

Responsibilities

• Maintain provider credentialing files and up-to-date information for government and commercial payer applications.

Skills

Communication skills

Organizational skills

Driver's license

Internet-based office tools

Education

High school Diploma or GED

Bachelor’s degree preferred

Tools

CAQH

PECOS

NPPES

CMS/EHR systems

Job description

Integrated Services for Behavioral Health is seeking a Credentialing Specialist in Southeast Ohio. The role manages provider credentialing processes and helps with client billing and reimbursement workflows across Medicaid, with potential Medicare or private payer work.

The position emphasizes updating CAQH, PECOS, NPPES, and CMS databases, coordinating enrollment and recredentialing, and ensuring timely credentialing for providers. Excellent organizational skills are essential.