Credentialing Specialist
Sage Dental Management is a leading, rapidly growing Dental Service Organization (DSO) committed to innovation, excellence, and patient-centered care.
Overview
Sage is looking for a Delegated Credentialing Specialist (Remote) to join our team! The Delegated Credentialing Specialist is responsible for organizing, maintaining, and verifying all aspects of the delegated credentialing process for General and Specialty Dentists. In all activities, they must comply with all legal and regulatory policies and procedures.
Responsibilities
Adhere to NCQA guidelines. Audit Provider Licensure Files to NCQA guidelines. Pull Monthly Delegated Verification Files in accordance with NCQA. Knowledge of Delegated Verification Websites (ie. National Provider Data Base, etc.) Understanding of Initial and Re-Credential Delegated files / processing. Prepare and Present provider files for internal and external auditing. Upload and update the system and / or software with new documents. Request & Obtain any Licensure renewals. Must be able to utilize the licensure portals. Experience in Clearinghouse / Manual Education Verifications. Experience in Manual Hospital Privileges Verifications. Experience in Board Certification Verifications through the appropriate portals. Strong understanding of the differences between similar credentials (ie. Malpractice, Diplomas, etc.) Knowledge of what a Credentialing Committee consists of. Coordinate, monitor, maintain and process all internal re-credentialing to NCQA guidelines. Heavy Understanding of Attestation questions, actions, exclusions and explanations. Ability to speak effectively with providers, educators and internal departments. Assist offices and internal departments with credentialing issues. Ability to multi-task in a fast-paced environment. Work other projects as assigned. Qualifications ● Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)● Data Entry & Record Management● General Computer Knowledge● Keyboard Shortcuts● Typing Speed: 57 WPM● Time Management● Organization & Attention to Detail● Customer Service● Written & Verbal Communication● Self-Motivated● Flexible Scheduling● Team Collaboration● Confidential Information Handling What Sage Offers Be part of a purpose-driven organization transforming dental care. Collaborate with a passionate, innovative team. Access to cutting-edge technology and professional development resources. Competitive compensation and benefits. Apply To This Job