Dental Network Credentialing Specialist (Hybrid)

Superior Dental Care, Inc.; Centerville (OH); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

On-site fitness centers & gym" reimb.

On-site cafeteria at headquarters

Gym membership reimbursement

Discounts for employees

Cash rewards program

Job summary

Medical Mutual, headquartered in Ohio, is seeking a Hybrid role focused on the dental network. The position handles provider applications, credentialing processes, recruitment campaigns, and maintains ongoing relationships with providers and DSOs.

You will collaborate with Senior Dental Network Specialists, manage records and inquiries, and support Medicare Advantage compliance while contributing to a collaborative team culture in Centerville, OH.

Qualifications

• Knowledge of provider contracts, network arrangements and fee schedule structures.
• Knowledge of standard customer service best practices and principles.
• Knowledge of HIPAA requirements and healthcare privacy standards.

Responsibilities

• Works with Senior Dental Network Specialist(s) to support credentialing and the ongoing relationship management of both individual and Dental Service Organizations (DSO) providers.
• Utilizes various system platforms to maintain up-to-date provider and DSO records and financial information; processes provider claim pends and manages inquiries and submissions in a timely manner.
• Assists with technical support, provider registration, secure provider portal access and provider file monitoring.
• In support of Medicare Advantage compliance, facilitates processing updates for excluded and precluded providers based on CMS requirements.
• Assists Senior Dental Network Specialist(s) to ensure seamless support and effective teamwork.

Skills

HIPAA knowledge

Provider contracts

Credentialing experience

Customer service

Education

Associate degree in healthcare administration

Job description

Medical Mutual, headquartered in Ohio, is seeking a Hybrid role focused on the dental network. The position handles provider applications, credentialing processes, recruitment campaigns, and maintains ongoing relationships with providers and DSOs.

You will collaborate with Senior Dental Network Specialists, manage records and inquiries, and support Medicare Advantage compliance while contributing to a collaborative team culture in Centerville, OH.