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Summary

The Insurance Credentialing Specialist is responsible for quick and efficient credentialing
and recredentialing of our dental providers. They ensure full completion and accuracy of all incoming provider applications. Constantly collect and process verification and accreditation information and must constantly maintain and update accurate files for licensed professionals. This includes education, training, experience, and licensure. The
Specialist tracks credentialing by payor, and recredentialing acting as liaison with payors,
providers, and multi-departmental teams.

Essential Duties & Responsibilities

• Obtains all provider credentials and documentation from the Compliance team.

• Stores credentialing paperwork or electronic submissions for new providers and
• recertification of current providers within required timeframes. Ensures provider
• credentialing status with all approved payors for the location in which they work.
• Maintains and modifies a provider and location roster to share with payors during the
• enrollment process.
• Maintains accurate detailed records of all credentialing work in addition to emails and/
• or conversations with third party payors, doctors, practice teams.
• Reviews credentialing-related issues with payors to resolution
• Supports the credentialing function through all acquisitions to ensure efficient,
• accurate, and timely enrollment with insurance plans at PPO locations.
• Acts as liaison with third party payors to validate and/or correct entity and/or provider
• set-up in the third-party payors system.
• Builds strong relationships and communication bridges between Credentialing team
• and practice teams.
• Operates in compliance with all local, state, and Federal laws as well as Company policy
• and compliance standards.

Requirements

Basic Qualifications: Experience & Skills

• Two (2) Three (3) years of Dental or Medical Credentialing experience required (Dental
• preferred). Organization credentialing a plus. This is not an entry level position.

• Knowledge of dental insurance credentialing, ADA recommendations, CAQH Proview, and
• NPPES preferred.
• Strong familiarity with common dental practice information technology systems such as
• Practice Management Systems, telephony systems, and Microsoft applications.
• Experience with Payor online and paper credentialing application processes.
• Experience auditing and maintaining detailed complex credentialing records.
• Detail oriented with a high level of organization, analytical, and problem-solving skills.
• Excellent multi-tasker with ability to remain calm in fast-paced environments.
• Ability to work autonomously and efficiently within designated timeframes or deadlines.
• Proficient with Word and Excel.

• Strong verbal and written communication skills required.

Education

High School Diploma or equivalent and directly applicable experience

Benefits

SALT Dental Collective believes in providing Excellent patient care, Excellent employee experience, and Excellent practice performance. Career development and growth opportunities!

Competitive pay and solid benefits.