Job Description
Our Client, a Health Insurance company, is looking for a Provider Credentialing Specialist for their Detroit, MI / Hybrid location. Responsibilities:
+ Responsible for the processing of practitioner and organization/facility provider applications for credentialing and recredentialing; requesting primary source documentation, processing documentation requirements, verifying information received, updating information in the system of record, evaluating over all case categorization and reporting findings to the Medical Director and Enterprise Credentialing Committee.
+ Resolve inquiries related to credentialing file disposition.
+ Provide credentialing status information for group administrators, physicians and their staff, Provider
+ Services, Customer Service and Network Development Inquiries.
+ May bedesignated by the leader to attend Credentials Committee meetings and conduct internal meetings and participate in auditing processes...
+ Responsible for the processing of practitioner and organization/facility provider applications for credentialing and recredentialing; requesting primary source documentation, processing documentation requirements, verifying information received, updating information in the system of record, evaluating over all case categorization and reporting findings to the Medical Director and Enterprise Credentialing Committee.
+ Resolve inquiries related to credentialing file disposition.
+ Provide credentialing status information for group administrators, physicians and their staff, Provider
+ Services, Customer Service and Network Development Inquiries.
+ May bedesignated by the leader to attend Credentials Committee meetings and conduct internal meetings and participate in auditing processes...