Credentialing Specialist

Sage Dental; Boca Raton (FL); Remote; USD 37,000 - 47,000; Full time

Job summary

Sage Dental, a leading Dental Support Organization in the Southeast, is seeking a Credentialing Specialist to oversee the credentialing process for dentists. This remote role demands strong organizational and communication skills, with a focus on compliance with NCQA guidelines. Join a growing team dedicated to patient-centric care and innovative technology.

Qualifications

• Minimum 2-3 years’ experience in Healthcare Credentialing, Dental preferred.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Office products required.

Responsibilities

• Organizing, maintaining, and verifying the delegated credentialing process.
• Adhere to NCQA guidelines and audit provider licensure files.
• Coordinate internal re-credentialing to NCQA guidelines.

Skills

Communication

Organizational skills

Detail-oriented

Multitasking

Education

High School Diploma

Tools

Microsoft Office

Credentialing software

Job description

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Sage Dental is the leading Dental Support Organization (DSO) in the Southeast, and we are continuing to grow! At Sage, people are at the core of everything we do. We are looking for dynamic and talented professionals who fit our culture of innovative technology, constant learning, and patient-centric care to join our team. If you are ready to take the next step in your career and want a position with excellent earning potential with a stable, growing company, Sage Dental has what you are looking for.

Overview

Sage is looking for a Delegated Credentialing Specialist (Remote) to join our team! The Delegated Credentialing Specialist is responsible for organizing, maintaining, and verifying all aspects of the delegated credentialing process for General and Specialty Dentists. In all activities, they must comply with all legal and regulatory policies and procedures.

Responsibilities

• Adhere to NCQA guidelines.
• Audit Provider Licensure Files to NCQA guidelines.
• Pull Monthly Delegated Verification Files in accordance with NCQA.
• Knowledge of Delegated Verification Websites (ie. National Provider Data Base, etc.)
• Understanding of Initial and Re-Credential Delegated files / processing.
• Prepare and Present provider files for internal and external auditing.
• Upload and update the system and / or software with new documents.
• Request & Obtain any Licensure renewals.
• Must be able to utilize the licensure portals.
• Experience in Clearinghouse / Manual Education Verifications.
• Experience in Manual Hospital Privileges Verifications.
• Experience in Board Certification Verifications through the appropriate portals.
• Strong understanding of the differences between similar credentials (ie. Malpractice, Diplomas, etc.)
• Knowledge of what a Credentialing Committee consists of.
• Coordinate, monitor, maintain and process all internal re-credentialing to NCQA guidelines.
• Heavy Understanding of Attestation questions, actions, exclusions and explanations.
• Ability to speak effectively with providers, educators and internal departments.
• Assist offices and internal departments with credentialing issues.
• Ability to multi-task in a fast-paced environment.
• Work other projects as assigned.
  
  

Qualifications

• High School Diploma required.
• Minimum 2-3 years’ experience in Healthcare Credentialing, Dental preferred.
• Excellent verbal and written communication skills.
• Well organized and detail-oriented with the ability to multi-task.
• Proficiency with Microsoft Office products, including Word,Excel,Outlook, and Adobe required.
• Must be able to function with minimal supervision and be able to prioritize all work tasks.
• Designated workspace with high-speed internet and access to hot spot if needed.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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