Jobs in Whitby, United States

Credentialing Enrollment Specialist

(Remote)

Lead with GRATITUDE. Engage with EMPATHY. CARE with COMPASSION. BE Intellectually Curious. Be part of NADG's Tribe!

NADG is the fastest growing dental services organization of scale in the United States and today consists of a network of over 200+ dental practices in 15 states and 25 regional markets, and recently have become the first Transatlantic Dental Service Group! Our entrepreneurial culture and maniacal focus on patient care serve as a great platform to become an innovative and dynamic industry leader.

We are looking for a Credentialing Specialist to come and help us pioneer a new culture of dentistry. Join the tribe!

The Credentialing Specialist will work closely with the provider, revenue cycle team, field team and management to collect all items needed to obtain and maintain all payer participation. They will be responsible for processing applications and reappointment paperwork, checking for full completeness and accuracy. They accurately maintain and update databases.

• Initiates provider applications. Acts as point-of-contact between provider and field team, reviews returned applications and other data for accuracy and completeness.
• Performs initial applicant data entry into Echo database. Updates and maintains the database to ensure information is current. Updates payers with change in provider information.
• Prepares and maintains malpractice certificates and renewals, payer reappointments, and certificate/license renewals within the confines of deadlines.
• Prepares CAQH for newly affiliated and completes attestations for existing providers.
• Prepares and electronically submits provider enrollment applications to various carriers.
• Identifies payer application issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
• Collects and maintains payer contact information.
• Develops and maintains relationships with current and future payer representatives.
• Contacts payer representatives weekly to obtain application status.
• Becomes familiar with and performs necessary research of payers and their products.
• Monitors workload, communicates with supervisor on potential issues, adheres to credentialing due date for applicant processing.
• Performs auditing and reconciliation of provider assignment board and Echo database.
• Monitors and manages credentialing/recredentialing requirements.
• Consistently updates credentialing databases and designed spreadsheets with demographic information, current information and effective dates.
• Scans credentialing documentation into appropriate shared drives.
• Provides timely response to task tickets created in Track It system.

Experience/Requirements

• High School Diploma
• Prior credentialing and dental experience preferred
• An equivalent combination of training, educational background and experience in related fields and educational disciplines

Skills, Knowledge and Abilities (SKAs)

• Knowledge of Revenue Cycle process and impact on provider payer enrollment, strongly preferred.
• Problem solving—the individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
• Interpersonal Skills—the individual maintains confidentiality, remains open to others’ ideas and exhibits willingness to try new things.
• Oral communication—the individual speaks clearly and persuasively in positive or negative situations, demonstrates group presentation skills and conducts meetings.
• Written Communication—the individual edits work for spelling and grammar, presents numerical data effectively and is able to read and interpret written information.
• Planning/organizing—the individual prioritizes and plans work activities, uses time efficiently and develops realistic action plans.
• Quality control—the individual demonstrates accuracy and thoroughness and monitors own work to ensure quality.
• Adaptability—the individual adapts to changes in the work environment, manages competing demands and is able to deal with frequent change, delays or unexpected events.
• Dependability—the individual is consistently at work and on time, follows instructions, responds to management direction and solicits feedback to improve performance.
• Safety and security—the individual actively promotes and personally observes safety and security procedures, and uses equipment and materials properly.

Benefits

• Health, Dental and Vision Insurance (Full-time employees)
• Healthcare Spending Account
• Paid Time Off
• 401k
• Voluntary Life & Disability Insurance
• Referral Program
• Employee Discount Program

Physical/Environmental

• Sitting and bending for long periods of time.
• Position requires frequent talking, hearing, and vision with moderate standing, walking and reaching.
• Extensive computer usage.
• Job position responsibilities are generally performed in a business office environment with computers, printers and phones, remote.

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.

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