Credentialing Specialist

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Sage Dental

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1997

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2012-09

Healthcare • Healthcare Insurance • Pharmaceuticals

Sage Dental is a leader in comprehensive dental care with over 30 years of experience, offering a wide array of services including general dentistry, endodontics, orthodontics, pediatric dentistry, periodontics, and oral surgery. With more than 140 practices across the southeastern United States, Sage Dental emphasizes a modern, family-friendly approach to dental health and focuses on delivering exceptional patient care while fostering a team-driven culture that values growth and innovation. Their commitment to using the latest clinical advancements ensures that patients receive high-quality treatment in a convenient setting.

📋 Description

• Organize, maintain, and verify all aspects of the delegated credentialing process for General and Specialty Dentists • Comply with all legal and regulatory policies and procedures • Adhere to NCQA guidelines • Audit provider licensure files to NCQA guidelines • Pull monthly delegated verification files in accordance with NCQA • Prepare and present provider files for internal and external auditing • Upload and update systems/software with new documents • Request and obtain licensure renewals • Process initial and re-credentialing delegated files • Coordinate, monitor, maintain, and process internal re-credentialing to NCQA guidelines • Manage attestation questions, actions, exclusions, and explanations • Communicate with providers, educators, and internal departments • Assist offices and internal departments with credentialing issues • Work on other assigned projects

🎯 Requirements

• High School Diploma required • Minimum 2-3 years’ experience in Healthcare Credentialing, Dental preferred • Excellent verbal and written communication skills • Well organized and detail-oriented with the ability to multi-task • Proficiency with Microsoft Office products, including Word, Excel, Outlook, and Adobe required • Must be able to function with minimal supervision and prioritize all work tasks • Insurance/Payer Application submission experience • Designated workspace with high-speed internet and access to hot spot if needed • Knowledge of NCQA guidelines and delegated credentialing processes • Experience with licensure portals and credential verification websites • Experience in Clearinghouse / Manual Education Verifications • Experience in Manual Hospital Privileges Verifications • Experience in Board Certification Verifications through appropriate portals

🏖️ Benefits

• Competitive compensation and benefits • Access to cutting-edge technology • Professional development resources • Remote work / telecommuting