Quality Home Care - Your Home, Your Standard of Care
Home Care Credentialing and Provider Enrollment Specialist
Location
Michigan
Posted
113 days ago
Salary
0
Seniority
Mid Level
Job Description
Home Care Credentialing and Provider Enrollment Specialist
Quality Home Care Michigan
• Maintain and update CAQH ProView profiles for all providers • Complete initial and re-credentialing applications with Medicare, Medicaid, and commercial payers • Track enrollment status, follow up with payers, and ensure timely approvals • Maintain credentialing files, audit documentation, and compliance reports • Collaborate with operations and billing teams to support reimbursement and network participation • Monitor expiration dates and manage re-credentialing processes • Act as a liaison between providers, payers, and internal teams to resolve credentialing issues
Job Requirements
- 2+ years of provider enrollment or healthcare credentialing experience, preferably in non-skilled home care in the state of Michigan
- Strong knowledge of CAQH ProView, Medicare PECOS, Medicaid portals, and commercial payer systems
- Excellent attention to detail, organization, and follow-up skills
- Ability to manage multiple tasks and meet deadlines
- Strong verbal and written communication skills
- Experience with credentialing software or tracking systems is a plus
- Prior experience with non-skilled home care licensing requirements in the state of Michigan
- Knowledge of provider contracting and network participation
- Familiarity with auditing credentialing and compliance documentation specifically in the state of Michigan
Related Guides
Related Categories
Related Job Pages
More General Jobs
Referral Specialist
ComPsychThe World’s Largest Provider of Mental Health Services and GuidanceResources® for Life.
• Issue referrals to local providers to ensure clients are evaluated within five (5) business days • Educate referral contacts, providers, and facilities about procedures for management initiated referrals • Ensure that treatment providers complete all the necessary paperwork • Act as a clinical consultant to providers to ensure that clients are referred to the most appropriate level of care and/or services • Complete follow-up with clients, treatment providers, and referral contacts through completion of services • Communicate verbally and/or in writing with referral contacts regarding clients’ compliance with treatment, discharge planning, and aftercare services • Provide clients with supportive counseling, when necessary • Follow all guidelines and requirements as indicated by the employer or federal guidelines • Document all referral and clinical information in our database • Act as a liaison between clients and their benefit plan to ensure access for recommended treatment • Other duties as assigned
• Responsible for primary clinical support in assisting sales representatives to develop new sales opportunities. • Provide technical expertise, product demonstrations, patient care, installation and maintenance of company products. • Develop and maintain relationships with physicians and staff at assigned clinical sites. • Provide case support, including Operating Room/Procedure support. • Work with sales, marketing, and R & D personnel to communicate product information.
• Record from your own home studio • Provide 24 hour turn around on projects • Be able to record pickup lines as requested by clients • Master tracks prior to delivery
Patient Service Agent
Anne Arundel DermatologyLeading dermatology provider in the Mid-Atlantic and Southeastern regions.
• Efficiently handle 80-100 inbound/outbound calls each day. • Master internal systems and tools (phone system, EHR, etc.). • Views and manages provider scheduling and communications. • Collects and manages patient information with respect and detail, in accordance with industry regulations (HIPAA, PHI, etc.). • Consults with patients to schedule and re-schedule appointments. • Actively listens to patients and effectively communicates, using empathy and concern, both verbal and written. • Escalates patient situations that require unique attention. • Achieves and surpasses individual monthly performance goals.
