1 Dental Credentialing and Payer Relations Specialist Job in Blue, OH

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Dental Credentialing and Payer Relations Specialist

Cordental Group

Blue, OH | Full Time

$125k-145k (estimate)

10 Months Ago

Dental Credentialing and Payer Relations Specialist

$125k-145k (estimate)

Full Time | Ambulatory Healthcare Services 10 Months Ago

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Cordental Group is Hiring a Dental Credentialing and Payer Relations Specialist Near Blue, OH

Overview:

CORDENTAL Group (headquartered in Cincinnati, OH) is a growing dental support organization (DSO) focused on bringing together only the best dental practices within the Mid-Atlantic, Midwestern and Southeastern U.S. to be THE DSO of choice!

What is the Credentialing and Payer Relations Specialist?

The Credentialing and Payer Relations Specialist understands billing contracts and their nuances and possesses a strong understanding of contracts to help practices resolve complex billing situations. The Credentialing and Payer Relations Specialist will assist in the enrollment of affiliated or employed dentists with appropriate payer programs and insurance plans, including but not limited to, Medicare, Medicaid, and other commercial or private payer plans.

ESSENTIAL FUNCTIONS include the following:

Works closely with both Credentialing Director and Central Billing Office Director to supports day-to-day activities related to the credentialing and contracting Cordental Group affiliated providers with insurance and treatment facilities.
Monitors requests to add/remove practitioners to facilities in assigned locations.
Sends application materials, reviews returned applications for completeness, follow up on any outstanding information or additional information needed, and performs primary source verifications. Follows up with non-responsive providers and assist with obtaining credentialing packets and other documentation.
Works closely with the Central Billing Office Team and the dental practices to help resolve complete dental billing situations.
Enter and update practitioner information in the credentialing database and maintaining data integrity standards.
Maintains knowledge of current health plan and agency requirements for credentialing providers.
Sets up and maintains provider information in online credentialing databases and system.
Work effectively with individuals across multiple departments throughout the organization
Ensures practice addresses are current with health plans, agencies and other entities.
Audits health plan directories for current and accurate provider information.
Facilitates physician or group enrollment with payers as directed by Credentialing Director or CBO Director.
Completes all required compliance training.
Duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally, either verbally or in writing.

Full Time employees are eligible for comprehensive package including competitive salary, benefits package, paid time off, and company annual matching 401k program.