Job Description

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Job Description:

The Credentialing Specialist (Revenue Cycle) will serve to support all insurance payor relationships, including provider credentialing and enrollments, with the goal to establish stronger positions in markets represented by Specialized Dental Partners (SDP) in various dental specialties.

About Us:

Specialized Dental Partners, a private equity backed firm in 36 States, is the exclusive management services group for endodontists, periodontists, and other specialized dentists. We partner with top tier specialized dentists throughout the United States to collaborate and grow their practices so they can pursue clinical excellence without getting mired in the administrative side of the business and without relinquishing clinical autonomy. Specialized Dental Partners provides comprehensive operational, marketing, and administrative support services, reinvests resources, and applies best practices and innovative technologies to improve clinical and financial performance resulting in steadier, more profitable growth for all. The result is that our partners are able to do more of what they love while securing their professional futures.

Experience:

3 - 5 Years

• Serve to support overall relationship with insurance payors.
• Collaborate with practices to plan, strategize and support insurance payor credentialing needs.
• Support all provider credentialing and re-credentialing activities in a manner that mitigates the risk of financial losses, coordinate efforts with operational leaders through the on boarding process.
• Maintain provider files, payor participation information, including expirable documents.
• Complete all applications for payor credentialing and re-credentialing in a timely manner; obtain appropriate documents from various resources to complete payer applications, as needed.
• Assist to identify, and resolve timely, any payor enrollment-related under-payment / non payments.
• Assist to develop SOPs, training, and development of new colleagues on payor contracts.
• Communicate with other departments within the Practice Support Services, & practice-based teams,
• Other duties as assigned.

Qualifications & Characteristics:

• Demonstrate positive energy when interacting with internal and external colleagues.
• Demonstrate meaningful knowledge in payor contracts data & market competition reviews.
• Super user of data, with expert knowledge in analytical functions, to support decision-making.
• Excellent organizational, communication & time-management skills.
• Ability to pay attention to detail and to follow-through.
• Advocate of Specialized Dental mission, vision and values.

Education & Experience:

• Associates degree or equivalent experience
• Prior experience in revenue cycle, practice management or payor relationship is preferred.

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