Provider Enrollment Rep II

Mortenson Dental Partners•Louisville, KY

10d•Onsite

About The Position

The Provider Enrollment Rep II is responsible for completing and submitting credentialing and recredentialing applications for insurance participation accurately and in a timely manner. This role involves tracking application status, managing expiring provider credentials, gathering required documents, and submitting rosters to carriers. The position also requires entering quarterly data into national databases like CAQH and TMHP, maintaining credentialing information, and responding to departmental inquiries regarding provider network status, file updates, and network changes. Additionally, the role involves communicating updates to stakeholders and performing other administrative duties.

Requirements

High School Diploma or equivalent
Dental or medical administration experience
Computer proficiency
Basic Excel skills

Nice To Haves

Associate's Degree
Experience with the provider credentialing process
Proficient in Excel
Proficient in credentialing software
Proficient in Google Suite

Responsibilities

Completes and submits credentialing and recredentialing applications for insurance participation in an accurate and timely manner by following department guidelines.
Tracks application status until an effective date is given.
Tracks expiring provider credentials and communicates necessary updates appropriately and timely.
Gathers required documents and submits rosters to carriers to assist with delegation.
Enters current quarterly data on the national CAQH database, TMHP website, and other carrier websites as required when prompted.
Collects and maintains all credentials and submits new versions when issues arise to keep credentialing status current.
Triage and responds to departmental inquiries, including provider network status inquiries, updating provider files, and network changes.
Communicates timely updates to stakeholders and performs various other administrative duties as needed.