Credentialing and Enrollment Specialist

Dental Care Alliance • Sarasota, FL

1d • Remote

About The Position

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

The Credentialing and Enrollment Specialist reports to the Senior Manager of Credentialing and Enrollment and manages credentialing for providers within an assigned territory. The role ensures providers are credentialed with insurance payors and that credentialing activities comply with regulatory standards. It also involves coordinating with payors and cross-functional teams, maintaining records and reports, resolving credentialing issues, and supporting process improvements.

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 DCA credentialing SaaS reports.
• Proven experience collaborating with high-performing teams to achieve operational goals.

Responsibilities

• Execute non-delegated credentialing for new and existing providers, completing credentialing and re-credentialing applications accurately and on time.
• Act 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, up-to-date records of credentialing applications, approvals, and renewals.
• Lead and mentor a team of credentialing specialists, providing guidance and support for strong performance and professional development.
• Address and resolve issues or discrepancies arising during the credentialing process.
• Generate and analyze credentialing activity reports and identify trends and areas for improvement.
• Collaborate with revenue cycle, operations, and clinical leadership to align insurance plan management strategies with organizational goals.
• Identify opportunities for process improvements, technology implementation, and innovation in insurance plan management.

What This Job Offers

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