Credentialing Specialist – Elevate Dental Care & Compliance

D4C DENTAL BRANDS, INC.; Atlanta (GA); In loco; USD 42.000 - 65.000; Tempo pieno

Vantaggi offerti da questo lavoro

Paid time off

Medical, dental and vision benefits

401K

Health Savings Account

Descrizione del lavoro

D4C Dental Brands is seeking a Credentialing Specialist to coordinate credentialing and re-credentialing activities across commercial and Medicaid dental plans. You will liaise with practitioners, health plans, hospitals and care facilities to ensure enrollment and coverage accuracy and compliance.

Responsibilities include CAQH management, document collection, and timely application monitoring, with updates to provider information and expiring licenses.

Competenze

• High school diploma; Bachelor's degree preferred.
• 2-3 years experience in Managed Care credentialing and Medicaid enrollment.
• Experience with integrating dental practices and acquisitions.
• NAMMS Certifications is a plus.

Mansioni

• Liaise between practitioners, health plans, hospitals, patient care facilities and all related entities regarding credentialing, malpractice coverage, and practitioner enrollment.
• Manage credentialing and re-credentialing processes and complete applications for Commercial and Medicaid dental plans; contact doctors for additional documents; monitor applications for timely approval.
• Manage CAQH applications including completion and updates; maintain provider information in credentialing databases.
• Update addresses, NPI data, and other provider information with health plans and agencies.
• Prepare reports and correspondence related to credentialing; maintain knowledge of current plan requirements and renewals.

Conoscenze

Credentialing knowledge

Communication skills

Attention to detail

Time management

Formazione

High school diploma

Bachelor's degree preferred

Strumenti

CAQH

Online credentialing systems

Descrizione del lavoro

D4C Dental Brands is seeking a Credentialing Specialist to coordinate credentialing and re-credentialing activities across commercial and Medicaid dental plans. You will liaise with practitioners, health plans, hospitals and care facilities to ensure enrollment and coverage accuracy and compliance.

Responsibilities include CAQH management, document collection, and timely application monitoring, with updates to provider information and expiring licenses.