Credentialing Specialist

What you'll do…

The Credentialing Specialist's primary role is to collect the appropriate provider documentation to enroll the provider in all the dental plans with which Great Expressions is contracted and the provider is eligible with. This position will be responsible for submitting initial enrollment applications, and all associated follow up on those applications. The Credentialing Specialist will also be responsible for verifying the accuracy of all submitted credentialing and enrollment information.

This position is located at our corporate office in Southfield, MI and has a hybrid schedule of Monday, Tuesday, Thursday in office and Wednesday/Friday remote.

What you'll bring to the team…

Responsible for preparing enrollment applications for new and established providers within a regionEnsures that applications are completed accurately, comprehensively and are sent out in a timely mannerOrganizes credentialing-related files and verifies that required documents for applications are collected from providersValidates that information on required documents match enrollment applications and ensure there are no discrepanciesRecognizes, investigates, and validates discrepancies in information obtained from providersSubmits enrollment applications, stores record of submissions and provides payors with additional information to if requestedFollows up with payors proactively on pending applications in advance of a provider's start dateCollects effective date from payors and stores confirmation of enrollmentMaintains practice management system with accurate information - submission dates, follow-up dates and effective dates as well other required dataResponsible for Medicaid enrollment applications and re-validations prior to expiration dateResponds to directory validation and other such requests from payorsProactively provides updates to regional team on providers and statuses on enrollment with payors and responds to any ad-hoc inquiriesDemonstrates the ability to effectively prioritize tasks and set short/long term goals to achieve themExpresses thought clearly, concisely, and effectively both verbally and in writing. Ensures a free flow of information and communication upward, downward, and across the organization by actively listeningCompiles, evaluates, and presents the provider specific data collected for review by one or more decision making bodiesAssist with all re-credentialing requestSorts and handles mailOther tasks as requested by direct Manager

What we require you have…

Associates degree or equivalent credentialing experience

Prior experience with dental/health credentialing & provider enrollmentCPCS or CPMSM certification a plusProficiency in Microsoft Outlook and ExcelExcellent Communication skills and customer focusAnalytical and problem solving skills with a passion for detail & accuracyReliability and flexibility with time committed to the positionExcellent organizational and time management ability

About GEDC…Since 1982, Great Expressions has been at the forefront of dental innovation, setting the standard for exceptional care and unforgettable patient experiences. Now, we're entering a new era of transformation, and we want you to be a part of it. Our recently appointed leadership team brings over a century of collective dental expertise and is backed by dynamic investment support to pave the way for groundbreaking changes. We're channeling our resources and energy into revolutionizing our technology platform, expanding service offerings, and creating a personalized patient experience that goes beyond the expected. At Great Expressions, we're not just transforming dentistry; we're investing in the growth and development of our team. Join us and be a part of a career that blends innovation and professionalism, where your contribution shapes the future of dental excellence.

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