Credentialing Specialist - Dental Network
BizTek People, Inc. | APA International Placement Consultants•Evansville, IN
•Onsite
About The Position
This role manages provider data, verifies documentation, and ensures compliance with credentialing standards and regulatory requirements. The position also supports provider directory maintenance and network reporting.
Requirements
- Must have at least 1+ years of credentialing experience (medical or provider experience accepted)
- Must be tech savvy with credentialing software and Excel
- Must have HS Diploma or GED
Nice To Haves
- Prior insurance industry knowledge and familiarity with terminology is preferred
Responsibilities
- Coordinate initial credentialing and re-credentialing for network dentists
- Verify credentials through primary sources including CAQH and NPDB
- Maintain accurate provider records including licensure, DEA, malpractice coverage, and claims history
- Track credentialing documentation and maintain audit trails
- Prepare credentialing documentation for leadership approval
- Manage provider contracts and fee schedules
- Maintain and update Commercial and Medicare provider directories
- Upload updated directories to health plans monthly
- Run provider adequacy and accessibility reports
- Process provider updates and notify providers upon completion
- Support accounting with TIN verification as needed
- Assist with provider termination notifications to members
- Serve as a point of contact for provider offices and leased network partners
Benefits
- Free parking
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
