Home Care Credentialing and Provider Enrollment Specialist
Job Description:
- 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
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
Benefits: