Role and Responsibilities This position is responsible for assisting the Credentialing and Compliance Manager with provider enrollment credentialing to enforce regulatory compliance and quality assurance to ensure that all information meets federal and state guidelines. Maintains knowledge of standards in state and federal regulations and other governing organizations. Assists with the on-boarding process in relation to provider enrollment credentialing and notifies applicant of obligation to produce required information in a timely fashion. Verifies, researches, and responds to telephone inquiries and written inquiries, from providers, health care insurance companies and other departments, pertaining to credentialing and enrollment status in a professional and courteous manner. Provides credential information as directed to health care plan insurance companies, government programs, and collaborating organizations of programs as directed. Maintains all additions, terminations, and changes to all payors plans as appropriate. Prepares and submits provider enrollment applications forms to insurance payors including but not limited to BCBS, Medicare, Medicaid, etc. Maintains credentialing with web-based systems, such as CAQH, Availity, DOL, etc. and other health care plan insurance web-based system profiles as necessary. Maintains information up to date for the organization and individual providers to ensure billing and compliance. Utilizes technical knowledge of database management, operation of standard equipment including a personal computer and general knowledge of word processing, spreadsheet and database applications. Research, resolves, and documents provider inquiries regarding the status of health care plan applications/updates via telephone, email, hardcopy or in the system. Notifies applicant of obligation to produce information requested for a proper evaluation of his/her experience, background, training, demonstrated ability, previous performance and current competence. Prepares routine correspondence to submit to the provider. Maintains provider records and files accurately, including required documentation for physicians and all mid-level providers. Tracks and follows up on provider expirations, DEA, NPI numbers, license, and billing ID numbers. Performs other duties as assigned. Qualifications and Education Requirements Associate degree in health information management or related field or an additional four (4) years of relevant experience in lieu of degree. Minimum of two (2) years' provider enrollment credentialing experience in a health care environment. Working knowledge of Availity, CHAMPS, CAQH, BCBS Provider Secured Services/Provider Enrollment and Change Self-Services, NPDB, NPPES, PECOS, and Provider Enrollment Healthcare Plans in AL, CA, CT, DE, FL, GA, ID, IL, IN, IA, MD, MA, MI, MN, NE, NJ, NY, NC, OH, OR, PA, SD, and WI. Strong verbal and written communication skills. Excellent organizational skills. Qualifications and Education Preferred Bachelor's degree in health information management or related field or an additional four (4) years of relevant experience in lieu of degree.

Job Type:

Full-time Pay:

$50,000.00 - $54,000.00 per year

Benefits:

401(k) 401(k) matching AD&D insurance Dental insurance Disability insurance Employee assistance program Flexible spending account Health insurance Health savings account Life insurance Paid time off Retirement plan Tuition reimbursement Vision insurance

Education:

Associate (Preferred)

Experience:

provider enrollment credentialing: 1 year (Preferred)

Work Location:

Hybrid remote in Ann Arbor, MI 48105