Credentialing Representative - Tampa, FL
Full Time
Tampa, FL 33634
Posted
Job description
Overview
We have an excellent opportunity for a Credentialing Representative to join our organization. The Credentialing Representative is responsible for spreadsheet reconciliation, Eaglesoft linkage, monthly Medicaid verifications, assisting with dentist enrollment, and other duties related to dental provider credentialing.
Essential Duties and Responsibilities
- Reconcile monthly, weekly and biweekly extracts from contracted insurance carriers to ensure accuracy of provider demographic information and credentialing status.
- Completes network accuracy reconciliations and audits.
- Assists with initial credentialing, additional location requests (office-adds) and recredentialing as needed.
- Completes monthly state Medicaid verifications for all dentists.
- Saves and enters welcome letters upon receipt into specialized internal database.
- Maintain credentialing and insurance carrier electronic folders and files.
- Respond to carrier requests received via email and phone.
- Properly link dentists and hygienists in EagleSoft.
- Other duties and special projects as assigned.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Knowledge, Skills and Abilities
Provider credentialing or dental insurance experience a plus.- Advanced MS Outlook, Word and Excel.
- Ability to multi-task and manage several projects at one time.
- Ability to work in a fast-paced environment.
- Ability to handle sensitive information and maintain confidentiality.
- Ability to work independently and in a team environment.
Qualifications (Experience, Education, Licensure, Certification)
Associate degree and/or equivalent experience.
Working Conditions
Credentialing Representative will work in areas that are highly visible and designed and furnished to make a good impression. Most work stations are clean, well lit, and relatively quiet. Work is primarily sedentary in nature.
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