Job Description
Full job description
Job Summary
The Medicaid Billing & Credentialing Specialist is responsible for managing all aspects of Indiana Medicaid billing, claims submission, payment posting, denial management, and provider credentialing and enrollment. This role serves as the primary point of contact for all billing and credentialing functions and works closely with clinical staff and leadership to maximize reimbursement, maintain compliance, and ensure uninterrupted service delivery. The ideal candidate brings deep, hands-on experience with Indiana Medicaid billing processes and the specific portals and tools used in the state.
Responsibilities
Billing & Claims Management
Submit, track, and follow up on all Indiana Medicaid claims using the Indiana Health Coverage Programs (IHCP) Provider Portal and Availity
Verify client eligibility and benefit coverage through Availity and the IHCP Portal prior to service delivery
Post electronic and paper payments from Medicaid, managed care organizations (MCOs), and other third-party payers accurately and in a timely manner
Research, correct, and resubmit rejected and denied claims; prepare and submit appeals as necessary
Work aging accounts receivable on a regular cycle to resolve outstanding balances
Reconcile billing records with service delivery logs to ensure accuracy and compliance
Maintain complete and accurate billing and accounts receivable records
Monitor and apply updates to Indiana Medicaid fee schedules, billing codes, and policy changes
Generate billing reports for leadership including revenue summaries, denial trends, and collections data
Credentialing & Provider Enrollment
Manage the full credentialing and re-credentialing lifecycle for all providers (3–10 therapists) with Indiana Medicaid, managed care plans, and other payers
Complete and maintain provider enrollment applications through the IHCP Provider Portal, CAQH, NPPES, and other required systems
Maintain individual provider files with current licenses, certifications, NPI numbers, and other required documentation
Monitor credentialing expiration dates and initiate timely renewals to prevent lapses in billing eligibility
Complete revalidation requests issued by government payers
Terminate enrollment with government and commercial payers upon resignation or termination of providers
Serve as the primary liaison between providers, payers, and leadership regarding credentialing and enrollment status
Compliance & Documentation
Ensure all billing and credentialing activities comply with Indiana Medicaid regulations, HIPAA, and organizational policies
Maintain audit-ready documentation for all billing and credentialing processes
Stay current on changes to Indiana Medicaid regulations, DCS billing requirements, and managed care policies
Collaborate with clinical staff to ensure proper documentation supports billing codes submitted
Requirements
REQUIRED QUALIFICATIONS
Minimum of 5 years of direct experience billing Indiana Medicaid (required — this is non-negotiable)
Demonstrated proficiency using Availity for eligibility verification, claims tracking, and payer communications
Demonstrated proficiency using the Indiana Health Coverage Programs (IHCP) Provider Portal for claims submission, provider enrollment, and eligibility verification
Proven experience with provider credentialing and enrollment processes, including CAQH and NPPES
Strong knowledge of Indiana Medicaid billing codes, fee schedules, and reimbursement policies
Experience with Medicaid managed care organizations (MCOs) operating in Indiana (e.g., Anthem, CareSource, MDwise, MHS)
High school diploma or equivalent required; associate’s degree or higher in healthcare administration, billing/coding, or related field preferred
Strong attention to detail with excellent organizational and time management skills
Ability to work independently and manage multiple priorities in a small-team environment
Proficiency in Microsoft Office Suite (Excel, Word, Outlook)
PREFERRED QUALIFICATIONS
Experience billing for behavioral health or mental health services specifically
Certified Professional Biller (CPB) or Certified Professional Coder (CPC) certification
Experience with electronic health record (EHR) systems and practice management software
Experience with Upheal or similar clinical documentation platforms
Knowledge of CPT, HCPCS, and ICD-10 coding related to behavioral health services
HOW TO APPLY
Interested candidates should submit a resume and brief cover letter highlighting their Indiana Medicaid billing experience. Please include specific examples of your experience with Availity and the IHCP Provider Portal. Applications without demonstrated Indiana Medicaid billing experience will not be considered.
Pay: $23.00 - $26.00 per hour
Work Location: Remote
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Job Summary
The Medicaid Billing & Credentialing Specialist is responsible for managing all aspects of Indiana Medicaid billing, claims submission, payment posting, denial management, and provider credentialing and enrollment. This role serves as the primary point of contact for all billing and credentialing functions and works closely with clinical staff and leadership to maximize reimbursement, maintain compliance, and ensure uninterrupted service delivery. The ideal candidate brings deep, hands-on experience with Indiana Medicaid billing processes and the specific portals and tools used in the state.
Responsibilities
Billing & Claims Management
Submit, track, and follow up on all Indiana Medicaid claims using the Indiana Health Coverage Programs (IHCP) Provider Portal and Availity
Verify client eligibility and benefit coverage through Availity and the IHCP Portal prior to service delivery
Post electronic and paper payments from Medicaid, managed care organizations (MCOs), and other third-party payers accurately and in a timely manner
Research, correct, and resubmit rejected and denied claims; prepare and submit appeals as necessary
Work aging accounts receivable on a regular cycle to resolve outstanding balances
Reconcile billing records with service delivery logs to ensure accuracy and compliance
Maintain complete and accurate billing and accounts receivable records
Monitor and apply updates to Indiana Medicaid fee schedules, billing codes, and policy changes
Generate billing reports for leadership including revenue summaries, denial trends, and collections data
Credentialing & Provider Enrollment
Manage the full credentialing and re-credentialing lifecycle for all providers (3–10 therapists) with Indiana Medicaid, managed care plans, and other payers
Complete and maintain provider enrollment applications through the IHCP Provider Portal, CAQH, NPPES, and other required systems
Maintain individual provider files with current licenses, certifications, NPI numbers, and other required documentation
Monitor credentialing expiration dates and initiate timely renewals to prevent lapses in billing eligibility
Complete revalidation requests issued by government payers
Terminate enrollment with government and commercial payers upon resignation or termination of providers
Serve as the primary liaison between providers, payers, and leadership regarding credentialing and enrollment status
Compliance & Documentation
Ensure all billing and credentialing activities comply with Indiana Medicaid regulations, HIPAA, and organizational policies
Maintain audit-ready documentation for all billing and credentialing processes
Stay current on changes to Indiana Medicaid regulations, DCS billing requirements, and managed care policies
Collaborate with clinical staff to ensure proper documentation supports billing codes submitted
Requirements
REQUIRED QUALIFICATIONS
Minimum of 5 years of direct experience billing Indiana Medicaid (required — this is non-negotiable)
Demonstrated proficiency using Availity for eligibility verification, claims tracking, and payer communications
Demonstrated proficiency using the Indiana Health Coverage Programs (IHCP) Provider Portal for claims submission, provider enrollment, and eligibility verification
Proven experience with provider credentialing and enrollment processes, including CAQH and NPPES
Strong knowledge of Indiana Medicaid billing codes, fee schedules, and reimbursement policies
Experience with Medicaid managed care organizations (MCOs) operating in Indiana (e.g., Anthem, CareSource, MDwise, MHS)
High school diploma or equivalent required; associate’s degree or higher in healthcare administration, billing/coding, or related field preferred
Strong attention to detail with excellent organizational and time management skills
Ability to work independently and manage multiple priorities in a small-team environment
Proficiency in Microsoft Office Suite (Excel, Word, Outlook)
PREFERRED QUALIFICATIONS
Experience billing for behavioral health or mental health services specifically
Certified Professional Biller (CPB) or Certified Professional Coder (CPC) certification
Experience with electronic health record (EHR) systems and practice management software
Experience with Upheal or similar clinical documentation platforms
Knowledge of CPT, HCPCS, and ICD-10 coding related to behavioral health services
HOW TO APPLY
Interested candidates should submit a resume and brief cover letter highlighting their Indiana Medicaid billing experience. Please include specific examples of your experience with Availity and the IHCP Provider Portal. Applications without demonstrated Indiana Medicaid billing experience will not be considered.
Pay: $23.00 - $26.00 per hour
Work Location: Remote
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💡 Quick Summary
Seeking a career-building opportunity? The Indiana Medicaid Biller/Credentialing - Mental Health position is now open for candidates interested in the Work from home Jobs sector. This role in New York City offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Work from home Jobs is a plus.
