Credentialing Specialist - Delegated Programs

Heartland Dental LLC; Effingham, Northern (IL, KY); Hybrid; USD 52,000 - 68,000; Full time

Benefits offered by this job

Benefits package

Job summary

Heartland Dental is seeking a Delegated Credentialing Specialist to support the Dental Insurance Administration team. You will organize, verify, and maintain credentialing processes for our supported doctors, ensuring accuracy and timeliness across all verifications and files.

You will work on a team with one other Delegated Specialist, reporting to a DIA Supervisor, and you will manage delegated credentialing files, maintain license and certification expirations, and support audits and special

Qualifications

• Basic knowledge of insurance plans and Medicaid is recommended.
• Maintain accuracy and attention to detail in a fast-paced environment
• Intermediate experience with Microsoft Excel, Outlook, and Word
• Strong verbal communication skills and the ability to remain professional and courteous over the phone and through email with customers at all times
• Ability to prioritize, problem solve and multitask
• High level of maturity, personal initiative, and sound judgment.
• Maintain and Open, Positive and Flexible, “CAN DO” attitude.

Responsibilities

• Support all new doctors to Heartland by completing all verifications and paperwork.
• Complete a delegated credentialing file for each provider.
• Maintain spreadsheets for the delegated insurance companies.
• Prepare documents for our delegated committee for review.
• Complete audits for our delegated companies
• Maintain doctor’s re-credentialing for delegated companies.
• Communicate with insurance administrators to maintain up to date files on supported dentists
• Ensure accuracy of files by tracking the expiration of licenses and certifications
• Maintain up-to-date knowledge and understanding different insurance plans and Medicaid
• Support special projects for the Dental Insurance Administration team, reports, and other such projects to support the work of the Dental Insurance Administration Department
• Other projects as assigned

Skills

Microsoft Excel

Outlook

Word

Verbal communication

Multitask

Job description

Heartland Dental is seeking a Delegated Credentialing Specialist to support the Dental Insurance Administration team. You will organize, verify, and maintain credentialing processes for our supported doctors, ensuring accuracy and timeliness across all verifications and files.

You will work on a team with one other Delegated Specialist, reporting to a DIA Supervisor, and you will manage delegated credentialing files, maintain license and certification expirations, and support audits and special