ID: 550946
NationalDental Front Office Job Posting
Confidential Employer

Description

We are seeking a full-time credentialing specialist for Full Smile Management! Join our team and grow your career with a company who encourages creativity and diversity, and provides endless opportunities for personal growth and professional advancement. We provide the support our team members need to maintain and ensure a heathy work-life balance. The Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing, enrollment, and privileging processes for all dental providers within Full Smile Dental’s clinical entities. This position ensures all providers are properly enrolled and credentialed with insurance plans, hospitals, and patient care facilities in compliance with regulatory and payer requirements. The role requires strong attention to detail, organization, and communication skills to maintain up-to-date and accurate provider records while facilitating timely renewals, enrollments, and verifications. Duties/Responsibilities - the Credentialing Specialist is responsible for, but not limited to, the following duties: Complete provider credentialing and re-credentialing applications; monitor application progress and follow up as needed. Coordinate initial enrollment with dental and medical insurance companies, ensuring compliance with payer policies. Maintain current and accurate data for all providers in credentialing databases and online systems. Track license, DEA, malpractice, and certification expirations to ensure timely renewals. Manage all aspects of dental provider onboarding related to credentialing and enrollment. Maintain corporate provider contract files and ensure practice addresses are current with health plans, agencies, and other entities. Conduct fee negotiations and perform data analysis on top billing codes when necessary. Audit payer directories for accuracy and compliance. Communicate effectively with providers, practice managers, and internal teams to obtain necessary documentation and resolve credentialing issues promptly. Maintain confidentiality of provider information at all times. Provide credentialing and privileging verifications as requested. Remain knowledgeable of current payer, agency, and regulatory credentialing requirements. Perform other related duties as assigned. Education and Experience Requirements: High school diploma or equivalent required; associate or bachelor’s degree in healthcare or business administration preferred. Minimum of three (3) years of experience in provider credentialing required. Certified Provider Credentialing Specialist (CPCS) certification required. Dental credentialing experience strongly preferred. Knowledge and understanding of the credentialing process. Ability to organize and prioritize work and manage multiple priorities. Excellent verbal and written communication skills including, letters, memos and emails. Ability to research and analyze data. Ability to work independently with minimal supervision. Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization. Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources. Job Type: Full-time Expected hours: 36 – 40 per week Benefits: 401(k) 401(k) matching AD&D insurance Dental insurance Disability insurance Employee discount Health insurance Health savings account Life insurance Paid time off Parental leave Referral program Relocation assistance Vision insurance Work Location: In person