Credentialing Specialist

Covenant Community Care Detroit , MI 48222

Posted 1 week ago

Covenant Community Care, a faith-based non-profit Community Health Center is looking for a full-time Credentialing Specialist who will perform all tasks related to the credentialing of all applicable Covenant Community Care employees. This ideal candidate will have strong computer skills, including proficiency in Microsoft Office applications, SharePoint, internet research, and web-based portals.

Specific Duties

  • Initial Credentialing

  • Maintains copies of current provider licenses

  • Completes provider enrollment and periodic re-enrollment applications; monitors applications and follow-ups as needed

  • Submits facility enrollment and re-enrollment applications when applicable for Medicare and Medicaid

  • Completes Provider Hospital Privileging as necessary

  • Communicates with providers and staff to educate them on health plans accepted at CCC

  • Communicates with Health Plans and requests new contracts as needed

Knowledge, Skills and Abilities

  • Strong organizational skills

  • Detail oriented and ability to prioritize work

  • Takes initiative and monitors processes from start to finish

  • Ability to work independently with minimal supervision

  • Ability to establish and maintain effective working relationships with providers, management, staff, and external contacts

Required education:

  • Two years previous credentialing experience

  • Understanding of Medicare, Medicaid, and Commercial billing regulations

  • Knowledge of the healthcare revenue cycle

  • Previous experience with EHR systems

Job Type: Full-time

Covenant offers a generous benefits package including health, dental and vision care, short-term and long term disability insurance, paid holidays and vacation time annually.

Please apply directly on company website:

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Credentialing Specialist

Covenant Community Care