Ensure successful onboarding for new in network dental PPO, dental DHMO, and vision providers.
Enter provider application data into Salesforce System for tracking.
Review and manage incomplete information and gather necessary information from providers.
Conduct initial credentialing and recredentialing of providers in compliance with internal standards, policies, and procedures.
Assist in conducting Credentialing Delegation Reviews and prepare monthly and quarterly reporting as requested.
Manage pending/incomplete contracts and workflow to gather missing documents.
Communicate and follow-up on missing contract elements with Provider Network Recruitment.
Perform checks on contracts to ensure appropriate fee schedules are utilized.
Present credentialing files to various Delegated Entities and review for compliance.
Maintain provider and patient confidentiality and provide positive, supportive communication to providers.

Bachelor’s degree preferred or equivalent experience
0-2 years’ experience in Provider Relations and Credentialing or equivalent experience preferred
Excellent verbal and written communication skills
High level of accuracy and attention to detail
Ability to gain high level of knowledge involving intricate aspects Systems of Record
Strong customer service philosophy
Critical thinking and problem-solving abilities
Ability to thrive in a fast-paced environment and meet assigned deadlines
Demonstrated ability to adopt change to improve process, efficiency, and service.
Demonstrates consistency in accuracy, speed, and quality of work.

Award-winning culture
Inclusion and diversity as a priority
Performance Based Incentive Plans
Competitive benefits package that includes: Health, Vision, Dental, Short & Long-Term Disability
Generous PTO (including paid time to volunteer!)
Up to 9.5% 401(k) employer contribution
Mental health support
Career advancement opportunities
Student loan repayment options
Tuition reimbursement
Flexible work environments

Provider Onboarding and Credentialing Specialist

Key skills