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Credentialing Specialist
Location
Worldwide
Posted
61 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
Credentialing Specialist
beBright
WHO WE ARE At beBright, smiles are the most important part of every day. Founded with the purpose of creating smiles and providing superior dental outcomes with a dual specialty integrated care model, beBright is a leader in pediatric dentistry and orthodontics. Our doctor-owned and led shared services organization is centered around providing administrative and operational support with unlimited growth opportunities. POSITION SUMMARY beBright is seeking a highly organized and detail-oriented Credentialing Specialist to manage all aspects of provider and practice credentialing. This position will play a critical role in ensuring compliance and timely approval across payors and regulatory bodies by handling new provider credentialing, recredentialing, payor enrollments, and credentialing for new practices and locations. The ideal candidate will be adept at managing multiple priorities, meeting strict deadlines, and collaborating cross-functionally with teams such as Procurement, Operations, and Revenue Cycle Management. This is a remote position. Key Responsibilities Provider & Practice Credentialing - Manage initial credentialing for new providers across all specialties. - Oversee provider credentialing when expanding to new locations or practices. - Coordinate recredentialing efforts to ensure compliance with payor and regulatory timelines. - Process credentialing related to tax ID changes, name changes, or other organizational modifications. Payor Enrollment & Network Management - Credential providers and practices with new payor partners and maintain current relationships with existing payors. - Ensure timely completion of applications, documentation, and follow-up to minimize delays in network participation. - Track credentialing status across multiple payors and locations, proactively addressing pending or denied applications. New Practice & Location Expansion - Lead credentialing processes for new de novo practices and expansions. - Partner with internal stakeholders to ensure timely credentialing aligned with practice opening schedules. Compliance & Documentation - Maintain accurate and up-to-date credentialing files and records in accordance with industry standards. - Monitor regulatory and payor requirements to ensure ongoing compliance. - Generate reports and maintain tracking systems for credentialing timelines, expirations, and renewals. EFT Setup - Collaborate with practices to establish Electronic Funds Transfers (EFTs) - Assist new acquisitions in transitioning existing EFTs to bB banking - Ensure all EFT information is accurately set up and verified New Acquisitions - Partner with the Practice Administrator (PA) to address credentialing requirements - Coordinate malpractice insurance coverage and collect all necessary documentation - Manage the transition of all existing EFTs to bB banking - Verify completion and accuracy of all financial and compliance-related setups Cross-Functional Collaboration - Partner with the Procurement team to coordinate malpractice coverage and documentation. - Collaborate with Operations and Revenue Cycle Management teams to ensure credentialing supports timely billing and reimbursement. - Serve as a resource for providers and practice leaders regarding credentialing processes and status. Qualifications - Associate’s or Bachelor’s degree in Healthcare Administration, Business, or related field preferred. - Minimum of 2–3 years of experience in provider credentialing, ideally within a dental or healthcare setting. - Experience in Revenue Cycle Management is preferred. - Strong understanding of credentialing requirements, payor processes, and healthcare compliance. - Excellent organizational skills with proven ability to manage multiple projects and deadlines simultaneously. - Strong attention to detail and accuracy. - Exceptional communication and follow-up skills, with the ability to build effective relationships across teams and with external payors. - Proficiency in Microsoft Office Suite and credentialing management software. Benefits - Competitive salary commensurate with experience. - Comprehensive benefits package including health, dental, and vision coverage. - Retirement savings plan with employer safe harbor program. - Paid time off and holidays. - Remote work flexibility. - Continuing education opportunities to grow skills in credentialing and revenue cycle support.
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Vendor Credentialing Specialist (Temp)
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Senior Regulatory Affairs Specialist (12 Month Contract)
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Go to the Career Worklet on your Workday home page and View "Convatec Internal Career Site - Find Jobs". Thank you!
Specialist I, CRE
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