Top 1 Credentialing specialist Jobs in Lansing, Mi

UMH Sparrow Health System - Provider Enrollment Specialist
University of Michigan Health Sparrow —Lansing, MI
- Full-time
- Microsoft Excel
- Hospital
- Medical office experience
7d

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UMH Sparrow Health System - Provider Enrollment Specialist

University of Michigan Health Sparrow -
Lansing, MI

Apply Now

Job Details

Full-time
7 days ago

Qualifications

Microsoft Excel
Medical office experience
High school diploma or GED
Health insurance knowledge
Productivity software

Full Job Description

Job ID: 55061

Positions Location: Lansing, MI Job Description General Purpose of Job:

Description:

Positions Location: Lansing, MI

Job Description

General Purpose of Job:

The Provider Enrollment Specialist works to efficiently complete/maintain provider/practice enrollments, revalidations and any demographic changes with contracted and government payers for the reimbursement of services. Establish and verify all billing information for entry into EPIC to ensure efficient revenue flow. Problem solve enrollment issues with practicies, providers and revenue cycle areas.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

Educate and communicate with providers/practices the enrollment process required for payors to establish the billing process and how it relates to the provider's ability to provide patient care and reimbursement.
Obtain and communicate NPI(National Provider Information) numbers for new practices.

Maintain NPI numbers/practice locations in the NPI database.
Update and maintain all required information for CAQH(Council for Affordable Quality Healthcare) profiles.
Prepare and submit accurate applications for new practices/providers including EFT(Electronic Funds Transfer) /ERA(Electronic Remittance Advice) enrollments.
Consistently document work assignment progress, enrollment follow-up status, and relevant in-process tasks within the specified systems and time frames.
Validate completed enrollment information with supervisors for EPIC claim processing and revenue collection.
Facilitate revalidation/termination applications needed for all providers/practicies following the payer requirements.
Maintain all practice location and provider demographic changes with all insurance carriers and CAQH.
Work with supervisors/billers on denials referencing enrollment issues.
Maintain detailed provider enrollment files in electronic format, including electronically received documents and scanning of hard copy documents and document each stage of enrollment/re-enrollment process.
Ongoing training to remain current on enrollment requirements.
Work collaboratively with fellow team members to create, evaluate and maintain department workflows, processes, policies and systems.
Provides additional status reports and updates as needed.
Follows and maintains all confidentiality requirements with provider data.
Other projects as assigned.

Job Requirements

General Requirements

None

Work Experience

Two years multi-physician office experience Experience with EPIC and Echo/One App system applications preferred Two years related work experience in insurance credentialing and enrollment preferred.

Education

Associate degree in health care related field or 2 years equivalent experience in health care setting.

Specialized Knowledge and Skills

Excellent analytical and problem solving skills Knowledge of insurance enrollment systems including PECOS, WebDENIS, CHAMPS, CAQH. Microsoft Office skills including Word, Excel required. Knowledge of reimbursement process preferred

University of Michigan Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

#LI-MA1

Job Family

Administrative/Clerical

Requirements:

Shift

Days

Degree Type / Education Level

High School / GED

Status

Full-time

Facility

Sparrow Hospital

Experience Level

New Grad

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