Payor Audit & Credentialing Lead

Dental One As; Sarasota, Northern (FL, KY); Hybrid; USD 55,000 - 85,000; Full time

Benefits offered by this job

Medical insurance

Dental services

Life insurance

Vision insurance

Long-term disability

Flexible Spending Account

401K

EAP program

Supplemental insurance

Job summary

Dental One As in the United States, Florida, specializing in payor audits and provider enrollment, seeks a Specialist to ensure data integrity and compliance across enrollment and billing systems.

You will manage payor-initiated audits from intake through final responses, interpret contracts and regulatory requirements, and advise Credentialing and Revenue Cycle leadership while mentoring staff.

Qualifications

• Experience interpreting payor contracts and delegation agreements.
• Understanding regulatory requirements for credentialing and enrollment.
• Ability to assess compliance and revenue risk and escalate when needed.

Responsibilities

• Serve as subject-matter expert for payor audits from intake through resolution.
• Oversee delegated credentialing audits and ensure readiness against standards.
• Govern provider enrollment and billing data acrossDentalXchange and connected systems.

Job description

Dental One As in the United States, Florida, specializing in payor audits and provider enrollment, seeks a Specialist to ensure data integrity and compliance across enrollment and billing systems.

You will manage payor-initiated audits from intake through final responses, interpret contracts and regulatory requirements, and advise Credentialing and Revenue Cycle leadership while mentoring staff.