Remote Dental Credentialing Coordinators Needed for Insurance Company - Managed Care Staffers : Job Details

*Please answer the questions below when you apply to this position*

Our client, a large national Insurance Company located in Lombard, IL, is looking to hire a temporary (until the end of the year), possibly temp-to-hire Remote Credentialing Coordinator. The Credentialing Coordinator ensures the delivery of high-quality care to the clients members by monitoring and maintaining the integrity of dental provider data in compliance with industry standards and regulatory requirements. You will work with the Credentialing and Clinical Review teams to ensure provider audits are completed in an accurate and timely manner.

Essential Functions:

• Collect required data for reviews of required licensures, certifications, background searches, & training records.
• Ensure potential New Provider applications meet credentialing standards.
• Ensure accurate entry and maintenance of data utilizing various resources.
• Reviews initial & recredentialing applications for completeness, accuracy, and compliance with regulations, guidelines, policies, & NCQA credentialing standards.
• Identify any discrepancies & convey problems to Credentialing Manager.
• Enters, updates & maintains data from provider applications into credentialing database.
• Prepare & follow up on appropriate verifications of individual applications in accordance with credentialing standards, procedural guidelines, & strict timelines.
• Participate in the development & implementation of process improvements for the system-wide credentialing process.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.

Job Requirements and Skills:

• 5 years of credentialing, health provider relations, or related experience.
• Customer service and effective verbal and written communication skills.
• Knowledge of dental provider credentialing and accreditation principles, policies, processes, procedures, and documentation.
• Ability to maintain confidentiality and discretion in all communications.
• Advanced working knowledge of Microsoft Word & Excel, spreadsheeting, and database management.

If you or anyone you know is interested, qualified and immediately available please answer the below questions and send an updated resume to us for immediate review and consideration:

(This job listing is assigned to be sent to: Elizabeth.)

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