What are the responsibilities and job description for the Medicaid Compliance and Credentialing Specialist position at Newcap, Inc.?
At Newcap, Inc., our mission is to empower individuals to overcome poverty and achieve economic security. As a mission-driven Community Action Agency, we’re dedicated to building thriving communities where everyone has the opportunity to live with dignity and hope.
We are seeking a Medicaid Compliance and Credentialing Specialist to manage Medicaid claims, provider credentialing, and compliance processes. This role ensures seamless billing operations and accurate submissions while maintaining strict adherence to healthcare regulations.
What You’ll Do
Credentialing & Provider Enrollment
- Manage the credentialing process, ensuring providers meet Medicaid requirements.
- Maintain up-to-date records and handle renewals to prevent disruptions in reimbursement.
- Serve as the liaison between healthcare providers and insurers.
Medicaid Billing & Compliance
- Verify and enter Medicaid claims data, ensuring accuracy with ICD-10 and CPT coding.
- Monitor claims for timely reimbursement and resolve denials or discrepancies.
- Stay updated on Medicaid regulations, HIPAA compliance, and billing best practices.
Collaboration & Process Improvement
- Work with third-party billing companies to ensure efficient claims processing.
- Identify opportunities to streamline billing processes and enhance efficiency.
- Provide training and support on Medicaid billing compliance.
- Collaboration with Healthcare Providers and Insurers:
- Work closely with healthcare providers, insurance companies, and government agencies to resolve any billing issues, claims inquiries, or disputes in a professional manner.
What You Bring
Required
- Medical Billing & Coding Certification (e.g., CPC, CBCS)
- Medicaid billing experience or similar healthcare role.
- Experience with third-party billing companies and provider credentialing.
- Valid driver’s license.
Preferred
- Familiarity with CPT & ICD-10 coding.
Skills We Expect
Problem-Solving | Attention to Detail |Proactivity |Process Improvement |Strong Communication |Accountability |Critical Thinking |Flexibility
Why Join Newcap?
When you join Newcap, you’re not just starting a job—you’re becoming part of a mission-driven team that helps families and communities thrive.
We Provide
- Stability: Full-time, year-round employment with a flexible workweek.
- Time off: Over 4 weeks of paid time off, plus .
- Comprehensive benefits: Medical, dental, and vision coverage for you & your family.
- Retirement savings: 403b plan with company match & immediate vesting.
- Employee wellness perks: Disability coverage, health lifestyle savings, and more.
- Growth & Development: Ongoing training opportunities & career advancement support.
Ready To Make an Impact?
Apply now and become part of a team that’s transforming lives and building resilient communities!
Job Type: Full-time
Pay: $23.00 - $25.00 per hour
Benefits:
- 401(k) matching
- AD&D insurance
- Disability insurance
- Employee assistance program
- Flexible schedule
- Health savings account
- Referral program
Schedule:
- Monday to Friday
Ability to Commute:
- Green Bay, WI 54303 (Required)
Work Location: In person
Salary : $23 - $25
