Credentialing Specialist

Overview

Dental Credentialing Specialist

Summary: The Credentialing Specialist will conduct all aspects of credentialing doctors and contracting facilities with different insurance payors.

Position is 100% remote and we provide equipment and ongoing support.

Seeking candiates that live in Pacific and Mountain time zones.

Pay Range: $23.00-$26.00/hour (Based on experience)

CHOICE is the largest provider of pediatric dental care in the Southwest United States, and we pride ourselves on delivering high quality care to children in our communities.

What we provide to you as a CHOICE teammate:

• Care for your wellbeing and work-life balance
• Professional and personal growth
• Experienced leadership support
• Fun and supportive team dynamic with events and celebrations
• Comprehensive benefit package

Responsibilities

Essential Duties and Responsibilities: include the following. Other duties may be assigned.

• Enroll and revalidate doctors and facilities with payors
• Process applications for licensing, permits, certifications, insurances, and relevant credentialing documents
• Reviews incoming insurance correspondence and mail and maintain and update credentialing spreadsheets accordingly
• Verify doctors’ status for employment

• Reports issues and trends to appropriate management personnel in Central Billing Office (CBO) and works collaboratively to develop solutions
• Consistently demonstrates a positive and professional attitude at work
• Maintains stable performance under pressure and handles stress in ways to maintain relationships with doctors, payors, and co-workers
• Maintains compliance with established corporate and departmental policies and procedures, quality improvement program, customer service and productivity expectations
• Maintains satisfactory attendance and punctuality record 

• Provides supportive assistance to internal and external people regarding credentialing concerns/issues
• Answers incoming calls from payors and offices and returns calls, addressing questions or concerns in a professional and ethical manner
• Responsible for other relevant work functions, as requested

Qualifications

Education and/or Experience: 

• High school diploma or equivalent
• Experience with Microsoft Word and Excel preferred
• Minimum of 1 -2 years business office experience in a health care environment.
• Demonstrate in-depth knowledge and experience in the following technology solutions – practice management system, scanning, and internet-based insurance websites.
• Prior credentialing and contracting follow-up experience preferred.

• Detail oriented, organized, and take initiative with good follow through required.
• Ability to maintain detailed records
• Excellent customer service and communication, both verbally and in writing
• Ability to communicate and work with doctors and payors to get facilities contracted and doctors credentialed