Overview Dental Care Alliance’s mission is to advance the practice of dentistry by partnering with and supporting dental professionals to create a lifetime of healthy smiles. Headquartered in Sarasota, Florida, DCA currently supports over 400 allied practices and supports over 900 dentists across over 20 States. DCA’s allied practices represent all dental specialties and treat patients under more than 150 brand names. The Credentialing and Enrollment will report to the Senior Manager of Credentialing and Enrollment to manage the credentialing process for all providers within the organization within their territory. This role is critical in ensuring that all providers are properly credentialed with insurance payors and maintain compliance with regulatory standards. Responsibilities · Execution of Credentialing Process: Execute non-delegated credentialing process for new and existing providers, ensuring timely and accurate completion of all credentialing and re-credentialing applications. · Insurance Payor Relationships: Serve as a point of contact for all insurance payor relationships in assigned area, resolving any issues related to provider credentialing. · Compliance: Ensure that all credentialing activities comply with state, federal, and organizational regulations and standards. · Documentation: Maintain accurate and up-to-date records of all credentialing activities, including applications, approvals, and renewals. · Collaboration: Lead and mentor a team of credentialing specialists, providing guidance and support to ensure high performance and professional development. · Problem Resolution: Address and resolve any issues or discrepancies that arise during the credentialing process. · Reporting: Generate and analyze reports on credentialing activities, identifying trends and areas for improvement. Core Competencies Industry Knowledge: In-depth understanding of dental insurance industry practices, regulations, and trends, including a broad understanding of billing and cash collection nuances, to maximize insurance payments and benefits. Analytical Skills: Strong analytical and problem-solving abilities to interpret insurance data, identify trends, make informed decisions based on information provided by DCA’s credentialing SAAS reports Execution Experience: Proven track record in collaborating with high-performing teams to achieve operational goals. Expectations Collaboration: Work closely with cross-functional teams, including revenue cycle, operations, and clinical leadership, to align insurance plan management strategies with overall organizational goals. Continuous Improvement: Identify opportunities for process improvements, technology implementation, and innovation to enhance insurance plan management practices within the DSO. Qualifications Direct dental credentialing and enrollment experience 3 years or more – · Ability to travel up to 5% · Ability to work remotely

Description Please Note: This is a fully remote opportunity, however, applicants must reside in Michigan and be willing to travel for court appearances. About the Role Are you a seasoned claims professional who thrives on tackling complex challenges and making a real impact? Do you have a sharp legal mind, a passion for problem-solving, and the confidence to work independently at the highest level? If so, we want to hear from you! As a PIP Litigation Adjuster, you'll be at the forefront of our claims operation, handling high-exposure, complex No-Fault cases from investigation through resolution. This isn't your average desk job. You'll partner with top-tier legal talent, lead key initiatives, and play a critical role in shaping how our team operates and succeeds. Responsibilities Complex Case Management - Own and drive the investigation, evaluation, and resolution of severe, complex PIP injury files and intricate coverage issues - Navigate the most challenging jurisdiction and high-exposure files, including MCCA reinsurance coordination - Investigate and manage comprehensive non-medical cost components with precision and expertise Legal Partnership & Litigation Leadership - Build powerful working relationships with local counsel and Home Office Legal, demonstrating true litigation leadership - Prepare for and attend trials, hearings, and conferences, keeping management fully informed with sharp status updates and strategic resolution recommendations - Confer with trial counsel and craft detailed, high-quality trial reports SIU & Risk Strategy - Identify emerging risks, develop countermeasures for the most complex challenges, and support SIU involvement when needed - Work proactively to stay ahead of issues before they escalate Team Leadership & Growth - Step up as a mentor, train others, own office-level projects, and help inspire those around you - Drive team discussions and special project groups focused on improving morale, quality, and productivity - Take an active and consistent role in No-Fault operations-level projects, bringing energy and insight to every initiative Why You'll Love This Role ✅ 100% Remote - work from the comfort of your home ✅ Be a go-to expert in one of the most specialized areas of insurance law ✅ Work alongside experienced legal and claims professionals ✅ Make a meaningful difference on complex cases that truly matter ✅ Lead, grow, and make your mark at the operations level Ideal experience includes: - Michigan residency required at time of hire and throughout employment in the role - Ability and willingness to travel for court appearances - Deep experience handling complex Michigan PIP litigation - Strong independent judgment and decision-making skills - A natural collaborator who also knows how to lead from the front Ready to bring your expertise to a role where your skills are recognized, your leadership is valued, and every day brings a new challenge? Apply today! Qualifications - 7+ years of experience - Strong written and oral communications skills required - Good interpersonal, analytical, decision making and negotiation skills required - Customer service experience preferred - Expertise in legal liability, general insurance policy coverage and the ability to review and understand medical records to determine causality and medical necessity - The capabilities, skills and knowledge required is normally acquired through a Bachelor`s degree and/or 7+ years of directly related experience preferred - Ability to obtain proper licensing as required About UsPay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role. At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://LMI.co/Benefits Liberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law. Fair Chance Notices - California - Los Angeles Incorporated - Los Angeles Unincorporated - Philadelphia - San Francisco

Our Company Amerita Overview This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations. This role requires working knowledge of pharmacy benefits and prior authorization process. Shift: Monday-Friday 8:30am-5:30pm (CST) Responsibilities - Initiate, process, and oversee the clinical review of prior authorization requests for medication and supply, ensuring compliance with payer requirements and clinical guidelines. - Collaborate with healthcare providers, insurance companies, and patients to gather necessary clinical information and documentation to support prior authorization submissions. - Submit prior authorization requests accurately and in a timely manner, utilizing electronic submission platforms and following established protocols. - Knowledgeable to perform all PA functions. Qualifications - High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy - 1+ years pharmacy experience - Pharmacy or healthcare-related knowledge - Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication - Basic math and analytical skills - Intermediate typing/keyboard skills About our Line of Business Amerita, an affiliate of BrightSpring Health Services, is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness, and entrepreneurial spirit of a local provider. For more information, please visit www.ameritaiv.com. Follow us on Facebook, LinkedIn, and X. Additional Job Information Percentage of Travel: 0-25% Salary Range USD $21.00 - $26.00 / Hour

Role Description The EDI Specialist is responsible for the support and execution of EDI mapping activities, mainly in the area of Sales & Distribution or other business-required areas utilizing EDI technologies. The position is a core member of the USA SD/EDI Team working from Querétaro, MX. Main Tasks - Implementation Services: - Executes Project tasks assigned, i.e., developing EDI mapping specs, gap analysis, programming, configuration of EDI Axway or similar EDI platform. - Support Services: - Analyzes EDI & translation issues and provides independent solutions. - Reviews functional testing for new or changed transactions, system upgrades, and system enhancements. - Collaborates with internal/external customers, business units, and other IT groups to identify requirements, assess available technologies, and translate requirements into solutions. - Tracks and logs EDI data for resend and exception processing. - Monitors EDI-System and connected Sub-Systems. - Coordinates with external EDI Service Providers. - Handles incident management and change management through Level 2 help desk process. - Completes small EDI projects less than 40 Man Hours. - IT Knowledge Management: - Responsible for the development of documentation for internal processes, technical, and non-technical documentation. - Conducts knowledge sharing sessions with internal stakeholders or external stakeholders whenever necessary and requested. Qualifications - Bachelors in Computer Science or bachelor’s degree in a relevant field. - 5+ years of relevant IT and EDI experience. - Experienced working in an international, multi-cultural team with offshore programming resources. Requirements - Familiar with EDI Translator formats, processes, and standards. - Axway TSIM 3.7 or similar translator products. - General Linux/UNIX commands and scripting. - EDI standard formats, such as ANSI X12, EDIFACT for business transactions such as orders, invoices, etc. - Mapping to and from the EDI standard and SAP’s IDOC formats and reports, as well as able to code for proprietary formats and flat files. - Familiar with setting up communication protocols such as FTP, various secured FTPs, AS2 along with related scripting on Linux/Unix. - Excellent verbal, written, and presentation communication skills in English and Spanish. - Strong documentation skills. - Willing and able to travel up to 30%. Preferred Skills and Experience - Automotive/Manufacturing environment experience. - SAP experience.