Home Care Credentialing and Provider Enrollment Specialist

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Oversee and refresh CAQH ProView profiles for all healthcare providers

• Complete both initial and re-credentialing applications for Medicare, Medicaid, and commercial payers

• Monitor enrollment status, conduct follow-ups with payers, and ensure approvals are secured in a timely manner

• Maintain credentialing files, conduct audits of documentation, and prepare compliance reports

• Collaborate with operations and billing teams to enhance reimbursement processes and network participation

• Keep track of expiration dates and manage the re-credentialing workflow

• Serve as a liaison among providers, payers, and internal teams to address credentialing concerns

⛳️ Requirements

• At least 2 years of experience in provider enrollment or healthcare credentialing, preferably in non-skilled home care within Michigan

• Comprehensive knowledge of CAQH ProView, Medicare PECOS, Medicaid portals, and commercial payer systems

• Exceptional attention to detail, organizational abilities, and follow-up skills

• Capability to manage various tasks and adhere to deadlines

• Strong verbal and written communication proficiency

• Experience with credentialing software or tracking systems is advantageous

• Previous involvement with non-skilled home care licensing requirements in Michigan

• Understanding of provider contracting and network participation

• Familiarity with auditing credentialing and compliance documentation specifically in Michigan

🏝️ Benefits

• Competitive salary and comprehensive benefits package

• Opportunities for professional development and career advancement

• Supportive work environment with a focus on teamwork and collaboration

• Flexible scheduling options to promote work-life balance