Provider Enrollment Rep II

Mortenson Dental • Louisville, KY

9d

About The Position

By following department guidelines, completes and submits credentialing and recredentialing applications for insurance participation in an accurate and timely manner. 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. When prompted, enters current quarterly data on the national CAQH database, TMHP website, and other carrier websites as required. Collects and maintains all credentials and submits new versions when issues arise to keep credentialing status current. Triage and responds to departmental inquiries. This includes, but is not limited to, provider network status inquiries, updating provider files, and network changes. Communicates timely updates to stakeholders and performs various other administrative duties as needed.

Requirements

• High School Diploma or equivalent
• Dental or medical administration
• Computer, basic Excel

Nice To Haves

• Associate's Degree
• Provider credentialing process
• Proficient in Excel, credentialing software, Google Suite

Responsibilities

• Completes and submits credentialing and recredentialing applications for insurance participation in an accurate and timely manner.
• 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.
• 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.
• Performs various other administrative duties as needed.

What This Job Offers

• Career Level: Mid Level
• Education Level: High school or GED