Health Care VA (Credentialing,VOB & Patient Care)

We are looking for a dynamic and motivated Credentialing/VOB Specialist. In this role, you will own the credentialing process end-to-end including tracking, file review, issue resolution, and roster auditing.
Essential functions include all aspects of medical provider credentialing, management of provider records, as well as the following:
Coordinates on-boarding process for new providers
Compiles and maintains current and accurate data for all providers for all service locations.
Completes provider payer enrollment applications; monitors applications and follows-up as needed.
Completes physician credentialing applications and obtains appropriate signatures. Handles re-credentialing as needed.
Follows all appropriate requirements set by the State of Michigan
Maintains copies of current state licenses, DEA certifications, malpractice coverage and any other required credentialing documents for all providers
Maintains knowledge of current health plan and agency requirements for credentialing providers
Sets up and maintains provider information in credentialing databases and systems.
Tracks license and certification expirations for all providers to ensure timely renewals.
Ensures practice addresses are current with health plans, agencies, and other entities.
Audits health plan directories for current and accurate provider information
Maintains confidentiality of provider information.
Provides credentialing and privileging verifications.
Monitors credentialing process and regularly follows up with third party payors.
Relays information to management and the billing department.
Builds and maintains professional relationships with third party payors.
Position may also include:
Verification of Benefits for new and current patients
Researching and resolving claim issues as related to non-payment.
Patient Care

WHAT YOU'LL NEED TO BE SUCCESSFUL IN THIS ROLE:
Experience:
Credentialing for providers licensed in Michigan, preferably in a behavioral health or medical office setting with the above areas of responsibilities. 2 yrs. Credentialing software experience a plus.
Experience credentialing providers with BCBSM, BCN, Aetna, Optum/United Healthcare, Medicare, HAP, Priority Health, PHP (Preferred ). 2 years
VOB with the insurance companies listed above: 2 years
Google Workspace (Preferred) or Microsoft Office: 1 year
HIPAA certification
Knowledge, Skills, and Abilities:
Skills in problem analysis and problem resolution.
Skills in computer applications.
Skills in oral communication.
Skills in planning and organizing.
Ability to communicate clearly.
Ability to multitask.
Ability to work pleasantly and efficiently with co-workers.
Ability to maintain a high level of confidentiality.
VOB/ Patient Communication Coordinator