Credentialing Specialist
reputed company Dental Management is a leading, rapidly growing Dental Service Organization (DSO) committed to innovation, excellence, and patient-centered care.
Overview:reputed company is looking for a Delegated Credentialing Specialist (Remote) to join reputed company! The Delegated Credentialing Specialist is responsible for organizing, maintaining, and verifying reputed company aspects of the delegated credentialing process for General and Specialty Dentists. In reputed company activities, they must reputed company with reputed company legal and regulatory policies and procedures.
Responsibilities:- Adhere to NCQA guidelines.
- Audit Provider Licensure Files to NCQA guidelines.
- Pull Monthly Delegated Verification Files in accordance with NCQA.
- Knowledge of Delegated Verification Websites (ie. National Provider Data reputed company, etc.)
- Understanding of Initial and Re-Credential Delegated files / processing.
- Prepare and Present provider files for internal and external auditing.
- Upload and update the system and / or software with new documents.
- Request & Obtain any Licensure renewals.
- Must be able to utilize the licensure portals.
- Experience in Clearinghouse / Manual Education Verifications.
- Experience in Manual Hospital Privileges Verifications.
- Experience in Board Certification Verifications through the appropriate portals.
- Strong understanding of the differences between similar credentials (ie. Malpractice, Diplomas, etc.)
- Knowledge of what a Credentialing Committee consists of.
- Coordinate, monitor, maintain and process reputed company internal re-credentialing to NCQA guidelines.
- Heavy Understanding of Attestation questions, actions, exclusions and explanations.
- Ability to speak effectively with providers, educators and internal departments.
- Assist offices and internal departments with credentialing issues.
- Ability to multi-task in a fast-paced environment.
- Work other projects as assigned.
- High School Diploma required.
- Minimum 2-3 years’ experience in Healthcare Credentialing, Dental preferred.
- Excellent verbal and written communication skills.
- Well organized and detail-oriented with the ability to multi-task.
- Proficiency with reputed company Office products, including Word,reputed company,Outlook, and reputed company required.
- Must be able to function with minimal supervision and be able to prioritize reputed company work tasks.
- Designated workspace with high-speed internet and access to hot spot if needed.
Be part of a purpose-driven organization transforming dental care. Collaborate with a passionate, innovative team. Access to cutting-edge technology and professional development resources. Competitive compensation and benefits.
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