Credentialing and Insurance Specialist - Dental Clinic

Summa Western Reserve Hospital•Akron, OH

41d•$23 - $27•Onsite

About The Position

This position serves as a liaison between the Dental Clinic providers, including residents, and payers, the hospital, and patients. This role's responsibilities include hospital and payer privileging, credentialing and enrollment, to ensure compliant revenue cycle activities. Additionally, this role serves as the gatekeeper for payer information and maintains accurate records and repositories of effective dates, contracted payers, and plan information..

Requirements

High school diploma or equivalent.
Three (3) years' experience in provider credentialing, managed care, physician office, and/or other healthcare-related environment to include experience with dental insurance verification, front-desk registration duties or related medical office roles, and experience working with an Electronic Health Record (EHR) system.
Working knowledge of dental/medical billing procedures, computers, calculators, and other equipment used in Financial Services.
Knowledge of medical or dental terminology and CDT codes.
Demonstrated understanding of the variations in insurance plans and requirements.
Ability to solve practical problems, interpret a variety of instructions furnished in written, oral, diagram or schedule form and to work reliably and with professionalism in a high-volume, high demand medical environment.
Proficiency in Microsoft Word, Microsoft Excel, and e-mail. Prefer skills in using health plan web sites.
Excellent organizational and communication skills.
Ability to work independently and productively as part of a team to reach decisions and solve problems
Good analytical skills necessary for problem solving.
Ability to maintain confidentiality of patient, employee, and financial information.
Ability to interact with populations of patients with an understanding for their needs of self-respect and dignity.

Nice To Haves

Associate Degree preferred
Prefer skills in using health plan web sites.

Responsibilities

Hospital and payer privileging, credentialing and enrollment
Ensure compliant revenue cycle activities
Gatekeeper for payer information
Maintains accurate records and repositories of effective dates, contracted payers, and plan information