What are the responsibilities and job description for the Credentialing Coordinator position at Big Smiles?
Credentialing Specialist
JOB OVERVIEW Responsible for all aspects of the credentialing and re-credentialing processes for all providers who provide patient care for the Smile Programs. Responsible for ensuring providers are credentialed with health plans. Maintain up-to date for each provider in credentialing databases and online systems; ensuring timely renewal of licenses and certifications.
Job Duties
Required license or certification
JOB OVERVIEW Responsible for all aspects of the credentialing and re-credentialing processes for all providers who provide patient care for the Smile Programs. Responsible for ensuring providers are credentialed with health plans. Maintain up-to date for each provider in credentialing databases and online systems; ensuring timely renewal of licenses and certifications.
Job Duties
- Compiles and maintains current and accurate date for all providers
- Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed
- Maintains copies of current state licenses, DEA certificates, malpractice coverage, and any other required credentialing documents for all providers
- Maintains knowledge of current health plan and agency requirements for credentialing providers
- Maintains information in credentialing database
- Managing relationships between insurance companies and nation-wide dental services organization (DSO)
- Articulate DSO priorities to other stake holders through email, phone or other communication tools
- Build relationships through email and phone with colleagues across the country to ensure collaborative success
- Utilize online portals, web-based platforms or other technology to achieve company’s success
- Communicate complex messages efficiently through email.
- Maintains confidentiality of provider information
- Provides credentialing and privileging verification
- Performs other duties as assigned
- Knowledge and understanding of the credentialing process
- Ability to organize and prioritize work and manage multiple priorities
- Excellent verbal and written communication skills including letters, memos, and emails
- Excellent attention to detail
- Ability to research and analyze data
- Ability to work independently with minimal supervision
- Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization
- Proficient use of Microsoft Office applications (Word, Excel, Access) and Internet resources
Required license or certification
- Driver's License
- High school or equivalent
