Medicaid Credentialing Specialist - Provider Enrollment

Integrated Services for Behavioral Health; Seaman (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 seeks a Credentialing Specialist in Southeast Ohio. The role processes provider credentialing, billing support and reimbursement-related operations.

Primary focus on Medicaid, with potential work with Medicare or private payers. Responsibilities include maintaining provider files, portals and CAQH/NPPES records, updating NPI applications, and coordinating credentialing and contracting with insurance companies.

Qualifications

• A high school Diploma or GED equivalent is required
• A bachelor’s degree in accounting, credentialing, or a related field is preferred

Responsibilities

• Maintain provider files for credentialing and payer portals
• Track CAQH, PECOS, NPPES, CMS portals and ensure logins are active
• Update CAQH files for CMS and payers as scheduled
• Complete new NPI applications
• Terminate enrollments when providers resign or are terminated
• Provide updated demographic information to external entities
• Maintain provider profiles on CAQH, PECOS, NPPES, CMS
• Coordinate credentialing, re-credentialing and contracting with insurers

Skills

Community service knowledge

Electronic health record systems

Communication skills

Organization skills

Driver's license

Auto insurance coverage

Deadline management

Internet-based office environment

Reliable high-speed internet

Education

High school Diploma or GED

Bachelor’s degree in accounting/credentialing/related field

Job description

Integrated Services for Behavioral Health seeks a Credentialing Specialist in Southeast Ohio. The role processes provider credentialing, billing support and reimbursement-related operations.

Primary focus on Medicaid, with potential work with Medicare or private payers. Responsibilities include maintaining provider files, portals and CAQH/NPPES records, updating NPI applications, and coordinating credentialing and contracting with insurance companies.