Credentialing Onboarding Specialist

Found in: Resume Library US A2 - 3 weeks ago

Atlanta Georgia, United States Benevis Full time
Overview:
Work for a company that is truly making the world a happier place, one smile at a time At Benevis, we create over a million smiles a year in the communities we serve and believe that every person deserves access to quality, affordable dental care. This mission drives everything we do. With over 3000 employees in offices across the country from clinical to support staff - we are united in our mission to create happy, healthy smiles through providing high quality dental care in a fun, compassionate environment. Are you ready to join us in creating our next million smiles? We have JUST the opportunity for you.

We are actively seeking a Credentialing On-Boarding Specialist to join our team. The Credentialing Onboarding Specialist reports to the Credentialing and Enrollment Manager and will be a key member of the Revenue Support Team. This role is primarily focused on ensuring the timely, accurate and efficient new provider onboarding and electronic billing support for all Benevis dentists and offices with payors. Find your opportunity to make an impact:

Responsibilities:
Prepares credentialing and re-credentialing Medicaid and Commercial applications of dentists and track all progression steps in internal database

Meets or exceeds individual productivity metrics, quality and timeliness standards as defined by department guidelines.

Query National Practitioners Databank, State Licensing Board, Office of Inspector General, etc.

Apply for Certificate of Insurance on behalf of the dentist

Review provider enrollment packets for missing information; requests missing information from provider; resolves discrepancies between information supplied and findings of other sources (NPDB, State Dental Boards, etc.)

Ability to accurately build provider records and to enter relevant information into the credentialing database and other ancillary data repositories as needed.

Ensure the provider’s credentials comply with requirements of contracted payers and well as preparing providers files for the credentialing committee according to NCQA regulations.

Maintains up-to-date physician database, including but not limited to medical licenses, drug enforcement administration certificates, professional liability insurance, provider numbers and renewal period expiration dates.

Confirm all required verifications are complete and have been performed according to required standard and within required timeframes.

Researches detailed information on provider status in response to telephone or written inquiries.

Researches and analyzes problems with enrollment packets and recommends resolutions

Runs queries, generates reports and credentialing document verification requests.

Qualifications:
 

Excellent administration skills high attention to detail

Proficient in using the Microsoft Office software applications (Excel, Word, PowerPoint)

Communicate effectively, both written and orally with dentist, payers, and co-workers

Excellent organizational/time management and project management skills and multi-tasking abilities

2 years of credentialing experience strongly preferred

CPCS certification and billing practice management experience is a plus

 

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