McLaren Health Care Credentialing Specialist in Flint, Michigan
Processes and maintains all provider and non-provider
applications for all MMG, subsidiaries and
MSO physicians for all insurance carriers.
Handles billing and revenue cycle inquiries as they relate
to provider enrollment issues. Serves as a liaison between the respective
offices and credentialing department.
Responsible for preparing credentialing applications for all carriers.
Responsible for obtaining necessary provider information to complete applications.
Responsible for setting up provider profiles in practice management system and storing of provider IDs in the computer system.
Maintains all group NPI’s and responsible for creating new NPI’s as needed by tax ID and specialty
Completes and maintains CAQH records.
Maintains Enrollment Worklist and releases claims held for credentialing issues once the issues are resolved or when provider enrolled with payer.
Maintains provider credentialing shared drive spreadsheet for all billing staff and management to utilize.
Produces reports for management staff to help identify and resolve credentialing issues.
Maintains and distributes weekly Physician Insurance Summary Report
Maintains and updates insurance credentialing information through attending seminars, keeping manuals current, and keeping current mailings on file.
Assists managers with training and educating employees on the credentialing process.
Serves as a liaison between credentialing, office staff, providers and carriers.
Performs related duties, as required.
School diploma and related courses.
2 years experience of physician billing and/or credentialing process.
knowledge of CAQH System, NPPES, BCBSM EDI TPA online application, CHAMPS, CMS
have knowledge of all third party carriers application and claims processing
guidelines as it relates to PIN info.
be able to communicate professionally with all providers, CEO’s VP’s and
Directors of all MHCC entities.
with Microsoft Office.
years within Physician Billing Department
Equal Opportunity Employer ofMinorities/Females/Disabled/Veterans
Primary Location: Michigan-Flint-Corporate Srvcs Building-MMG
Job Type Standard
Req ID: 21002965