Home Care Credentialing and Provider Enrollment Specialist

Job Description:

• Maintain and update CAQH ProView profiles for reputed company 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

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