Medical, Dental Contracting and Credentialing Specialist

Job not on LinkedIn

🔥 14 minutes ago

⏱ Part Time

🟡 Mid-level

🟠 Senior

Where this job comes from

Posted on Triton Medical Solutions's careers page ↗Triton Medical Solutions's careers page, not through a job board

First seen by Remote Rocketship 14 minutes ago

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Logo of Triton Medical Solutions

Triton Medical Solutions

51 - 200 employees

Founded 2011

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Triton Medical Solutions is a Tempe-based medical billing and practice management firm that specializes in medical and dental billing, revenue cycle management, insurance and Medicare contracting, and practice management consulting. The company offers end-to-end billing services — from claim submission and denial management to payment posting and transparent reporting — along with software for full practice management, EHR integration, verification of benefits, prior authorizations, and call center solutions. Triton serves physician and dental practices with customized B2B solutions aimed at increasing revenue, reducing denials, and streamlining administrative workflows while maintaining HIPAA compliance.

📋 Description

• Process and manage initial provider credentialing, recredentialing, and insurance network contracting applications • Submit applications and supporting documentation to insurance carriers and health plans • Communicate with insurance companies, healthcare providers, medical and dental office staff, and licensing agencies • Obtain required information and resolve application issues • Monitor application status and follow up with insurance carriers • Maintain and update provider credentialing and contracting records, electronic databases, and provider files • Complete primary source verifications and other required credentialing verifications • Register, maintain, and regularly update provider information in CAQH • Ensure provider credentials, licenses, certifications, and required documentation remain current • Understand applicable state and federal regulations and accreditation requirements related to credentialing • Respond to internal and external requests for provider credentialing and contracting information • Maintain records of provider participation, effective dates, network status, and demographic changes • Prepare and distribute credentialing reminders and scheduled reports • Serve as the primary point of contact for credentialing and contracting matters • Perform other duties as assigned • Independently manage multiple provider applications and follow-ups while supporting assigned client accounts

🎯 Requirements

• Previous healthcare insurance contracting and provider credentialing experience required • Hands-on experience with medical and/or dental provider enrollment and insurance network applications • Experience working directly with insurance carriers and health plans • Familiarity with CAQH, provider enrollment, recredentialing, and primary source verification • Certified Provider Credentialing Specialist (CPCS) certification preferred • Knowledge of state and federal credentialing regulations and AAAHC accreditation standards preferred • Ability to maintain confidential provider credentialing files and electronic databases • High level of professionalism and discretion when handling confidential information • Excellent organization, time management, problem-solving, and attention to detail • Self-directed work habits, accountability, and ability to work independently while managing priorities • Dedicated workspace, reliable computer, printer, and high-speed internet connection • Ability to meet Triton’s IT and security requirements • Approximately 20 hours per week availability • Ability to work as an Independent Contractor

🏖️ Benefits

• Flexible schedule • Part-time schedule of approximately 20 hours per week • Remote work arrangement • Independent Contractor work relationship • Use of own equipment and flexible scheduling

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