Dental Credentialing & Payer Ops Specialist

Platinum Dental Services; American Fork (UT); Vor Ort; USD 25.000 - 28.000; Vollzeit

Zusammenfassung

Platinum Dental Services in Utah is seeking a detail-oriented Credentialing Specialist to coordinate provider credentialing, enrollment, and fee schedule management across multiple states and locations. This on-site role requires strong organizational skills, meticulous data handling, and the ability to resolve payer issues by collaborating with internal teams and external representatives.

You will maintain CAQH profiles, monitor statuses, and support onboarding and acquisition-related

Qualifikationen

• Excellent attention to detail and commitment to data accuracy.
• Strong organizational skills with multi-project management.
• Proficient with Excel/Sheets and data analysis.
• Ability to work both independently and in a team.
• Willingness to learn complex insurance processes and payer requirements.
• Strong written and verbal communication.

Aufgaben

• Coordinate end-to-end credentialing and recredentialing for multiple states across locations.
• Prepare, review, submit, and track credentialing applications and enrollments.
• Maintain licenses, DEA registrations, malpractice coverage, CAQH profiles.
• Monitor statuses and escalate delays with payers as needed.
• Support onboarding, location changes, and payer participation updates.
• Verify provider participation, network affiliations, and effective dates.
• Assist with fee schedule analysis and payer network research.

Kenntnisse

Organizational skills

Attention to detail

Communication skills

Excel/Sheets proficiency

Research & analytical

Independent work

Privacy & compliance

Tools

Microsoft Excel

Open Dental

CAQH portals

Jobbeschreibung

Platinum Dental Services in Utah is seeking a detail-oriented Credentialing Specialist to coordinate provider credentialing, enrollment, and fee schedule management across multiple states and locations. This on-site role requires strong organizational skills, meticulous data handling, and the ability to resolve payer issues by collaborating with internal teams and external representatives.

You will maintain CAQH profiles, monitor statuses, and support onboarding and acquisition-related