Provider Credentialing & Enrollment Specialist

University of Michigan Health-West; Wyoming (MI); On-site; USD 42,000 - 64,000; Full time

Job summary

University of Michigan Health-West seeks a Provider Credentialing Specialist to manage credentialing workflows for physicians and healthcare professionals. You will handle applications, reappointments, and documentation with accuracy, while updating databases and communicating with billing teams.

The role requires attention to detail, coordination with licensing bodies, and the maintenance of current credentials and plan requirements to ensure compliance and timely renewals.

Qualifications

• High school diploma or equivalent.
• Associates degree preferred.
• Certified Provider Credentialing Specialist (CPCS) preferred.
• Two (2) years of relevant credentialing and/or healthcare experience.
• Knowledge of Microsoft Office (Excel, Word, Power Point, Access).
• Excellent customer service skills and willingness to be a team player.
• Excellent written and verbal skills are required, with emphasis on attention to detail.
• Ability to meet daily, weekly and/or monthly deadlines.
• Ability to organize and prioritize work and manage multiple priorities.

Responsibilities

• Compiles and maintains current and accurate data for all providers.
• Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
• Maintains copies of current state licenses, DEA certificates, malpractice coverage, CLIA licenses and any other required credentialing documents for all providers and facilities.
• Maintains knowledge of current health plan and agency requirements for credentialing providers.
• Apply for and maintain National Provider Identifier for all new and existing Providers.
• Ensures practice addresses are current with health plans, agencies and other entities.
• Maintains clear, consistent communication with the billing departments to resolve claims issues related to credentialing denials.
• Tracks license, DEA, CAQH, and professional liability expirations.
• Audits health plan directories for current and accurate provider information.

Skills

Credentialing

Data management

Regulatory compliance

MS Office

Communication

Attention to detail

Education

High school diploma

Associates degree preferred

CPCS certification preferred

Tools

Microsoft Excel

Microsoft PowerPoint

Microsoft Word

Microsoft Access

Job description

University of Michigan Health-West seeks a Provider Credentialing Specialist to manage credentialing workflows for physicians and healthcare professionals. You will handle applications, reappointments, and documentation with accuracy, while updating databases and communicating with billing teams.

The role requires attention to detail, coordination with licensing bodies, and the maintenance of current credentials and plan requirements to ensure compliance and timely renewals.