Credentialing/Enrollment Supervisor

4 weeks ago


Atlanta, Georgia, United States D4C Dental Full time

D4C Dental is seeking a skilled Credentialing/Enrollment Supervisor

Job Summary:

The Credentialing/Enrollment Supervisor plays a vital role in ensuring the quality of provider credentialing, privileging source verifications, and payer enrollment at D4C Dental. This position serves as a resource to and collaborates with others to advance the quality of providers and patient safety.

Key Responsibilities:

  • Support departmental activities to ensure quality in conducting, maintaining, and communicating provider credentialing, privileging source verifications, and payer enrollment.
  • Serve as a liaison between the credentialing group and new dental professionals.
  • Organize and facilitate the 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.
  • Manage CAQH applications, including completion and updates.
  • Maintain 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.
  • Prepare correspondence associated with the credentialing process.
  • Provide technical guidance, training, and mentoring to department staff.
  • Provide guidance, support, and recommendations to management.
  • Assist the department manager in directing work, monitoring performance, and attendance.
  • Assist the department manager in the development of performance appraisals.

Requirements:

  • High school diploma; Bachelor's degree in healthcare administration or a related field preferred.
  • NAMSS CPCS Certification a plus.
  • 5+ years of experience in managed care credentialing and payer enrollment.
  • 5+ years of medical staff services experience.
  • Experience with integrating dental practices and acquisitions.

Working Conditions/Physical Demands:

  • Office environment - Hybrid.


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