Credentialing and Enrollment Specialist

Dental Care Alliance • Sarasota, FL

21h • Remote

About The Position

Dental Care Alliance (DCA) partners with and supports dental professionals to advance dentistry and promote a lifetime of healthy smiles. Headquartered in Sarasota, Florida, DCA supports more than 400 allied practices and more than 900 dentists across over 20 states, with practices representing all dental specialties and operating under more than 150 brand names.

The Credentialing and Enrollment Specialist reports to the Senior Manager of Credentialing and Enrollment and manages the credentialing process for providers within an assigned territory. The role ensures providers are properly credentialed with insurance payors and that credentialing activities meet applicable regulatory standards. It also involves collaborating with internal teams, supporting process improvements, and leading and mentoring credentialing specialists.

Requirements

• At least 3 years of direct dental credentialing and enrollment experience.
• Ability to travel up to 5%.
• Ability to work remotely.
• In-depth understanding of dental insurance industry practices, regulations, and trends, including billing and cash collection nuances.
• Strong analytical and problem-solving skills, including the ability to interpret insurance data and credentialing SaaS reports.
• Demonstrated experience collaborating with high-performing teams to achieve operational goals.

Responsibilities

• Execute non-delegated credentialing for new and existing providers, ensuring credentialing and re-credentialing applications are completed accurately and on time.
• Serve as a point of contact for insurance payor relationships in the assigned area and resolve provider credentialing issues.
• Ensure credentialing activities comply with state, federal, and organizational regulations and standards.
• Maintain accurate, current records of credentialing applications, approvals, and renewals.
• Lead and mentor a team of credentialing specialists, providing guidance and support for performance and professional development.
• Address and resolve issues or discrepancies arising during the credentialing process.
• Generate and analyze reports on credentialing activities and identify trends and improvement opportunities.
• Collaborate with revenue cycle, operations, and clinical leadership to align insurance plan management strategies with organizational goals.
• Identify opportunities for process improvement, technology implementation, and innovation in insurance plan management.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed