Dental Network Specialist

Medical Mutual•Dayton, OH

4d•Hybrid

About The Position

To support the development and enhancement of the company’s dental network, this position handles provider applications, assists with the credentialing process, assists with recruitment campaigns, and manages ongoing relationships with both individual providers and Dental Service Organizations (DSOs) providers, guided by knowledge of corporate acceptance, participation, and professional review procedures.

Requirements

Associate degree in business or healthcare administration, communications or related field. Equivalent education and experience directly related to the role may substitute for a degree.
2 years of experience associated with provider network credentialling or equivalent customer service experience, preferably in dental insurance, dental providers office, or the healthcare/health insurance industry.
Intermediate MS Office skills.
Knowledge of provider contracts, network arrangements and fee schedule structures.
Knowledge of standard customer service best practices and principles.
Knowledge of Heath Insurance Portability and Accountability Act (HIPAA).

Responsibilities

Works with Senior Dental Network Specialist(s) to support credentialing and the ongoing relationship management of both individual and Dental Service Organizations (DSO) providers.
Utilizes various system platforms to maintain up-to-date provider and Dental Service Organization (DSO) records and financial information.
Processes provider claim pends and manages internal and external provider inquiries and submissions (such as those related to recruiting campaigns, contracting, and fee schedules) in a timely manner through multiple communication channels.
Assists with technical support, provider registration, secure provider portal access and provider file monitoring.
In support of Medicare Advantage compliance, works with Senior Dental Network Specialist(s) to facilitate processing updates for excluded and precluded providers based on the Center for Medicare and Medicaid requirements.
Assists Senior Dental Network Specialist(s) to ensure seamless support and effective teamwork.
Performs other duties as assigned.

Benefits

Laptop, monitors, keyboard, mouse and headset provided.
On-site fitness centers or gym membership reimbursement.
On-site cafeteria.
Discounts at many places.
Opportunity to earn cash rewards.
Business casual attire, including jeans.
Employee bonus program.
401(k) with company match up to 4% and an additional company contribution.
Health Savings Account with a company matching contribution.
Medical, dental, vision, life and disability insurance.
Employee Assistance Program.
Company holidays.
Up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
Parental leave for eligible employees who become parents through maternity, paternity or adoption.
Career development programs and classes.
Mentoring and coaching.
Tuition reimbursement up to $5,250 per year.
Diverse, inclusive and welcoming culture with Business Resource Groups.