Delegated Credentialing Specialist

Delegated Credentialing Specialist Dental Insurance Administration

As a Credentialing Coordinator at Heartland Dental you must be capable of handling a substantial amount of work in a fast-paced environment. Must apply a high degree of accuracy and exhibit excellent organizational skills. We are looking for a flexible team player who is professional and service-oriented at all times.

The Credentialing Coordinator will play a critical role supporting the Dental Insurance Administration team processes and projects. The credentialing coordinator is responsible for organizing maintaining and verifying all aspects of the credentialing process for our supported doctors.

Heartland Dental is the nations largest dental support organization providing non-clinical administrative support services to more than 3000 supported doctors across 39 states and the District of Columbia in 1900 dental offices. Each Heartland Dental supported office is unique to the community and the patients they serve. Supported doctors are the clinical leaders of their practice retain full clinical autonomy and establish their own care philosophies. All Heartland Dental supported doctors are united by a common goal: delivering the highest quality dental care and patient experiences.

To give you an idea of the team structure you will work on a team with 1 other Delegated Specialist reporting to a DIA Supervisor.

Below is an overview of the duties and responsibilities you would take on in this role:

• Support all new doctors to Heartland by completing all verifications and paperwork.
• Complete a delegated credentialing file for each provider.
• Maintain spreadsheets for the delegated insurance companies.
• Prepare documents for our delegated committee for review.
• Complete audits for our delegated companies
• Maintain doctors re-credentialing for delegated companies.
• Communicate with insurance administrators to maintain up to date files on supported dentists
• Ensure accuracy of files by tracking the expiration of licenses and certifications
• Maintain up-to-date knowledge and understanding different insurance plans and Medicaid
• Support special projects for the Dental Insurance Administration team reports and other such projects to support the work of the Dental Insurance Administration Department
• Other projects as assigned