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Home Care Credentialing and Provider Enrollment Specialist

Remote · South Korea Full-time

Job Description:

  • Maintain and update CAQH ProView profiles for all 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

Benefits:

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