Credentialing Onboarding Specialist

$54,000 - $55,000/Yr

New Benevis, Inc - Atlanta, GA

Full-time - Entry Level

Atlanta, GA

1,001-5,000 employees

About the position

The Credentialing Onboarding Specialist at Benevis plays a crucial role in the Revenue Support Team, focusing on the timely and accurate onboarding of new dental providers. This position is essential for ensuring compliance with credentialing requirements and facilitating electronic billing support for Benevis dentists and offices. The specialist will work closely with various stakeholders to maintain high standards of quality and efficiency in the credentialing process.

Responsibilities

• Prepares credentialing and re-credentialing Medicaid and Commercial applications of dentists and tracks all progression steps in the internal database.
• Meets or exceeds individual productivity metrics, quality, and timeliness standards as defined by department guidelines.
• Queries National Practitioners Databank, State Licensing Board, Office of Inspector General, etc. for Certificate of Insurance on behalf of the dentist.
• Reviews provider enrollment packets for missing information; requests missing information from providers; resolves discrepancies between information supplied and findings of other sources.
• Accurately builds provider records and enters relevant information into the credentialing database and other ancillary data repositories as needed.
• Ensures the provider's credentials comply with requirements of contracted payers and prepares providers' files for the credentialing committee according to NCQA regulations.
• Maintains up-to-date physician database, including medical licenses, drug enforcement administration certificates, professional liability insurance, provider numbers, and renewal period expiration dates.
• Confirms all required verifications are complete and have been performed according to required standards and within required timeframes.
• Researches detailed information on provider status in response to telephone or written inquiries.
• Researches and analyzes problems with enrollment packets and recommends resolutions.
• Runs queries, generates reports, and credentialing document verification requests.

Requirements

• Excellent administration skills with high attention to detail.
• Proficient in using Microsoft Office software applications (Excel, Word, PowerPoint).
• Effective communication skills, both written and orally, with dentists, payers, and co-workers.
• Excellent organizational/time management and project management skills with multi-tasking abilities.
• 2 years of credentialing experience strongly preferred.
• CPCS certification and billing practice management experience is a plus.
• Must reside in Atlanta or surrounding area.