Delegated Credentialing Specialist

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

Delegated Credentialing Specialist, Dental Insurance Administration

As a Credentialing Coordinator at Heartland Dental, you must be capable of handling a substantial amount of work in a fast-paced environment. Must apply a high degree of accuracy and exhibit excellent organizational skills. We are looking for a flexible team player who is professional and service-oriented at all times.

The Credentialing Coordinator will play a critical role supporting the Dental Insurance Administration team processes and projects. The credentialing coordinator is responsible for organizing, maintaining, and verifying all aspects of the credentialing process for our supported doctors.

Heartland Dental is the nation’s largest dental support organization, providing non-clinical administrative support services to more than 3,000 supported doctors across 39 states and the District of Columbia in 1,900+ dental offices. Each Heartland Dental supported office is unique to the community and the patients they serve. Supported doctors are the clinical leaders of their practice, retain full clinical autonomy, and establish their own care philosophies. All Heartland Dental supported doctors are united by a common goal: delivering the highest quality dental care and patient experiences.

To give you an idea of the team structure, you will work on a team with 1 other Delegated Specialist, reporting to a DIA Supervisor.

• 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

Minimum Requirements:

• 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.

We put our people first at Heartland Dental, and that shows in our generous benefits package.

Company retains the sole discretion to change the duties of the position at any time.

We provide all employees and applicants for employment the protections of federal, state, and local laws affording equal opportunity in employment.