The Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing, and related processes for all dental providers who provide patient care. They are responsible for obtaining, organizing and submitting all necessary information to the participating payers timely and accurately to ensure providers are credentialed at assigned locations and with the correct health plans. This includes maintenance for each provider in the credentialing databases and online systems and ensure timely renewal of licenses and certifications.
The Credentialing Specialist will communicate directly with Providers and Operational Stakeholders to inform current credentialing status, as well as resolve any related issues.
The Credentialing Specialist can work remotely but must be willing to travel to the Practice Support Center in Brentwood, TN if needed.
- Complete provider credentialing and re-credentialing applications and monitor pending applications and follows-up as needed.
- Maintain copies of current state licenses, malpractice coverage and any other required credentialing documents for all providers. Track license and certification expiration dates for all providers to ensure timely renewals.
- Set up and maintain provider information in online credentialing databases and system.
- Track Professional Liability expiration dates for providers.
- Audit health plan directories for current and accurate provider information, including current Practice information and locations.
- Maintain corporate provider contract files.
- Respond to all credentialing related inquiries
- Proactive in leading and supporting the Marquee Dental Culture by maintaining a positive, friendly, and supportive disposition.
- Credentialing Experience in a multi-provider healthcare environment, preferably dental
- Experience with Microsoft Office Suite, intermediate Excel skills a plus
- Excellent written and verbal communication skills
- Ability to communicate professionally to all stakeholders and team
- Ability to manage multiple provider files and associated timelines
- Bachelor’s degree preferred
Equal Opportunity Employer