Insurance Credentialing Manager

1 week ago


Chicago, Illinois, United States Bright Direction Dental LLC Full time
Job Title: Insurance Credentialing Specialist

Bright Direction Dental LLC is seeking a highly skilled Insurance Credentialing Specialist to join our team. As a key member of our support team, you will be responsible for overseeing and executing all facets of our credentialing program.

Responsibilities:
  • Follow through with the credentialing process for all existing and new affiliated offices and providers in accordance with participating standards.
  • Build strong and positive relationships and communication bridges between the BDD support team, practice teams, and payers.
  • Expeditiously respond to credentialing requests.
  • Manage the credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems and the appropriate and affected parties.
  • Utilize and maintain Credential Stream.
  • Coordinate the management of the electronic credentialing applications to ensure distribution, receipt, processing, and timely delivery to insurance payers.
  • Coordinate the management of the expiration process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
  • Monitor and report on the turnaround times of credentialing applications to ensure high accuracy and speed.
  • Prepare for and coordinate credentialing audits in compliance with existing insurance contracts.
  • Maintain Master Matrix of all par and non-par providers and facilities across all payers, and updates as needed when new contracts are executed and/or terminated.
  • Remain current with all related credentialing trends, regulatory requirements, and business strategies related to dentistry.
Requirements:
  • Bachelor's Degree preferred, but not required.
  • 2+ years of dental credentialing as the lead of the Compliance department.

Bright Direction Dental LLC is an equal opportunity employer. We prohibit discrimination and harassment of any type and afford equal employment opportunities to employees and applicants without regard to race, traits associated with race, creed, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.


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