Job Description

Job Location: FL Corporate Support - Tampa, FL 33634
Position Type: Practice SupportEducation
Level: 2 Year DegreeJob Purpose:
The Credentialing Representative is responsible for maintaining all dentist professional licenses, enrolling new dental providers with all insurance plans, maintaining in-network privileges for existing dental providers and other duties related to dental provider credentialing.
Duties and Responsibilities:
- Reconcile monthly, weekly and biweekly extracts from contracted insurance carriers to ensure accuracy of provider demographic information and credentialing status.
- Completes network accuracy reconciliations and audits.
- Assists with initial credentialing, additional location requests (office-adds) and recredentialing as needed.
- Completes monthly state Medicaid verifications for all dentists.
- Saves and enters welcome letters upon receipt into specialized internal database.
- Maintain credentialing and insurance carrier electronic folders and files.
- Respond to carrier requests received via email and phone.
- Properly link dentists and hygienists in EagleSoft.
- Prepare, print and submit existing provider re-credentialing applications to the insurance carriers for all employee dentists.
- Complete delegated re-credentialing for all active dentists prior to the 3-year re-credentialing cycle cutoff date.
- Responsible for all expired credentials including: Dental Licenses, DEA, Controlled Substance, Sedation Anesthesia Permits, Malpractice, and CPR cards.
- Partner with field office managers to resolve status requests and credentialing related claims issues.
- Other duties and special projects as assigned.
Knowledge, Skills and Abilities:
- Provider credentialing or dental insurance experience a plus.
- Advanced MS Outlook, Word and Excel.
- Ability to multi-task and manage several projects at one time.
- Ability to work in a fast-paced environment.
- Ability to handle sensitive information and maintain confidentiality.
- Ability to work independently and in a team environment.

Qualifications
- Credentialing experience, preferred.