Credentialing Supervisor

4 weeks ago

Atlanta, United States D4C Dental Brands Full time
D4C Dental Brands is seeking a Credentialing Supervisor

Must reside in Georgia

Job Summary:
The Credentialing Supervisor supports departmental activities to ensure quality in conducting, maintaining, and communicating provider credentialing, privileging, source verifications, and payer enrollment. Serves as a resource to, and collaborates with, others to advance the quality of providers and patient safety.

Education/Credentials:
  • High school diploma; Bachelor’s degree in healthcare administration, or related field preferred
  • NAMSS CPCS Certification a plus

Job-Related Experience:
  • 5+ years of experience in credentialing & payer enrollment
  • 5+ years experience with Medicaid and Commercial Insurance
  • 5+ years of  dental/medical staff services
  • DSO experience

Job-Related Skills/Competencies:
  • Ability to function in fast-paced work environment 
  • Excellent written, verbal, and communication skills 
  • Knowledge of dental or medical credentialing process
  • Proficient in Microsoft Office, specifically Word, Excel, and Internet and Outlook applications 
  • Strong attention to detail and accuracy
  • Ability to maintain confidentiality of provider information 
  • Strong desire to learn and to continually evolve to improve systems and processes 

Working Conditions/Physical Demands: 
  • Office environment - Hybrid

Major Duties and Responsibilities:
  • Serve as a liaison between the credentialing group and new dental professionals
  • Organize and facilitate company’s onboarding procedure for new hires
  • Work with state licensing agencies as necessary to assist dental professionals
  • Track license, malpractice and certification expirations for all practitioners to ensure timely renewals
  • Support requests for initial hospital appointment and reappointment when needed
  • Management of CAQH applications including completion and updates.
  • Maintains provider information in online credentialing databases and systems 
  • Coordinate, compile, and prepare reports pertaining to doctors as requested 
  • Document, organize and coordinate payer enrollment requirements
  • Assure that an appropriate knowledge base is maintained for use in enrolling 
  • Oversee the submission of payer enrollment applications for existing and new affiliate providers 
  • Remain current on industry trends, payer changes and market conditions as it relates to all plans
  • Preparation of correspondence associated with the credentialing process
  • Provide technical guidance, training and mentoring to department staff
  • Provide guidance, support and recommendations to management
  • Assist department Manager in directing work, monitoring performance and attendance
  • Assist the department manager in the development of performance appraisals
  • Perform other duties as assigned. 

Other Duties:This job description reflects management’s assignment of essential functions.  It does not prescribe or restrict the tasks that may be assigned.  Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

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