Dental Credentialing Specialist

Job Summary

To ensure compliance and maintain accurate provider data, the full-time remote Dental Credentialing Specialist will credential practitioners for network participation, manage provider files, and respond to inquiries regarding provider eligibility and status.

Key responsibilities

• Analyze credentialing applications and perform primary source verification for practitioner participation in networks
• Maintain provider files and the Provider Information Control (PICS) inventory workflow system, ensuring up-to-date information
• Respond to internal and external inquiries about provider participation and credentialing processes, focusing on customer service and resolution

Required qualifications

• High School Diploma or GED
• 3 years of experience in physician credentialing or health insurance/managed care operations
• Proficiency in Excel, including understanding of Pivot tables
• Knowledge of medical terminology and jurisdictional requirements related to credentialing
• Certification as a Provider Credentialing Specialist (CPCS) is preferred