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Credential Specialist

3 months ago

Englewood, United States Alfa Dental Support, Inc. Full time
Job DescriptionJob Description

As the Credential Specialist at Diamond Braces, you'll play a vital role in overseeing the credentialing, recredentialing, and privileging processes for all dental providers delivering patient care within our organization.

Your responsibilities will encompass ensuring that providers are credentialed, appointed, and granted privileges with various health plans. You will meticulously maintain accurate and current data for each provider within our credentialing databases and online systems, guaranteeing compliance with regulatory standards. Additionally, you will be instrumental in orchestrating the timely renewal of licenses and certifications, ensuring seamless continuity of care and uninterrupted service delivery.

This role is In-Person/Hybrid in our Englewood, NJ office.

Who We Are

At Diamond Braces, we believe in creating a brighter future and enhancing the quality of life through healthier smiles. Upholding our “No Smile Left Behind” philosophy, our mission is to offer customer-centric orthodontic care that is founded on Affordability, Accessibility, and Amazing customer service (the ‘AAA Experience’). We are committed to ensuring every individual can embrace the confidence that comes with a healthy and happy smile.

Since our founding in 2000, Diamond Braces has continued to earn the trust of thousands of clients and create better access to orthodontic care throughout the Tri-State area. We have created over 100,000 new smiles (and counting) and expanded to include multiple locations, with over 60+ Orthodontic practices providing high-quality care for our patients. Our vision is to treat patients and employees with the highest ethical standards.

Our goal for the future is to increase our footprint through underserved communities and provide quality orthodontic care for generations to come. We have become known for being one of the most experienced and affordable orthodontic providers, passionate about delivering expert care and making people smile.

What you can expect with a career at Diamond Braces:

  • Competitive salary
  • Health, Dental, and Vision insurance packages
  • PTO
  • 401(k) with company match
  • Discounted orthodontic care for you and your family
  • Ample growth & advancement opportunities

Essential Functions
  • Compile and maintain current and precise data for all providers within our network
  • Efficiently handle provider credentialing and recredentialing applications, ensuring thorough monitoring and follow-ups as necessary
  • Maintain organized records of current state licenses, DEA certificates, malpractice coverage, and any other vital credentialing documents for all provider
  • Oversee and manage corporate provider contract files, ensuring accuracy and accessibility
  • Remain updated on current health plan and agency requirements for provider credentialing, ensuring compliance at all times
  • Establish and maintain provider information within the CAQH system, ensuring completeness and accuracy
  • Track license and certification expirations for all providers, facilitating timely renewals to avoid disruption in service
  • Ensure that practice addresses are current with health plans, agencies, and other relevant entities, maintaining accuracy and consistency
  • Manage Diamond Braces appointment files and information within the credentialing database, ensuring thoroughness and accuracy
  • Conduct audits of health plan directories to ensure provider information is current and accurate
  • Uphold strict confidentiality standards regarding provider information, ensuring privacy and compliance with regulations
  • Provide credentialing verifications as needed, ensuring accuracy and promptness
  • Other duties as required and assigned by management

* Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
*Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.