Credentialing Specialist

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🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Sage Dental

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1997

💰 Private Equity Round on 2012-09

For over 30 years, Sage Dental has been a leader in comprehensive dental care, offering a wide range of services, including preventative, general, cosmetic, restorative, and specialty dentistry.At Sage Dental, our mission goes beyond providing exceptional patient care — we’re dedicated to building a team-driven culture that values growth, innovation, and compassion. Our modern, family-friendly approach focuses on creating healthier communities while supporting our employees with the tools and technology they need to thrive. From pediatric dentistry and orthodontics to teeth cleanings and oral surgery, we’re leading the way with the latest clinical advancements to ensure the best outcomes for our patients and their families.With over 140 practices across the southeastern United States, Sage Dental is committed to delivering all dentistry in one place, fostering convenience, quality, and collaboration. If you’re passionate about providing top-tier dental care and want to be part of a team that makes a difference, Sage Dental may be the perfect place for you to grow your career.Explore our opportunities and learn more about our mission at www.mysagedental.com/careers.

📋 Description

• 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.

🎯 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 be able to prioritize all work tasks. • Designated workspace with high-speed internet and access to hot spot if needed.

🏖️ Benefits

• 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.