Description We are offering a long term contract employment opportunity for a Credentialing Specialist in Cincinnati, Ohio. As a Credentialing Specialist, you will be involved in the management of all aspects related to the credentialing and re-credentialing process for Medicaid providers across Ohio state. Your role will involve ensuring adherence to both state and federal laws and regulations, as well as assessing provider qualifications to ensure they meet set standards. Responsibilities: • Oversee the coordination and processing of all initial credentialing and re-credentialing applications for the Ohio Medicaid staff within the stipulated timeline. • Review applications, check for completeness, follow up on missing items, and verify all licensure and certification credentials. • Communicate with health care providers and other professionals to gather required information, clarify information and answer any potential issues or concerns. • Ensure compliance with all policies, rules, and regulations related to credentialing as outlined by the Ohio Department of Medicaid. • Maintain up-to-date records and documentation of all education, licenses, residency, board certification, completed applications, credentialing verification, and malpractice information. • Participate in audits ensuring all credentialing processes are being followed as per state and federal regulations. • Respond to medical staff inquiries regarding credentialing application, verification processes, and related matters. Requirements • Proficient in auditing and compliance to ensure adherence to regulatory standards • Familiarity with the Council for Affordable Quality Healthcare (CAQH) is crucial • Proven experience in credentialing and understanding of credentialing processes • Knowledge of Medicaid billing and Medicaid claim procedures • Experience dealing with commercial insurance, particularly in the healthcare sector • Expertise in medical billing is a must-have • Ability to manage and maintain confidential and sensitive information • Strong attention to detail and the ability to work in a fast-paced environment • Excellent communication skills, both verbal and written • Ability to work in a team as well as independently • Proficiency in using computer applications relevant to the job role. Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .