Credentialing Specialist

Screens provider credentialing and re-credentialing packets for missing information; requests missing information from provider; resolves discrepancies between information supplied and findings of other sources (State Dental or etc.);
Creates and updates provider information in the credentialing system to ensure that credentials are completed within a timely manner and at a high level of accuracy.
Receives provider inquiries via phone and correspondence. Researches and verifies detailed information on provider participation status. Perform verification of all applicable credentials.
Contact providers for missing and expired information.
Processing mail; incoming and outgoing.
Performs miscellaneous duties as assigned.
Skills/Experience:
Job Requirements:

A high school diploma or GED is preferred, but candidates with proven experience will not be excluded from consideration.
A minimum of 2 years related experience.
Knowledge of Delta Dental products, policies and terms of provider participation in various networks is expected at conclusion of training and any applicable probationary period.
Ability to maintain confidentiality of providers information.
Demonstrated understanding of basic corporate structures and how to accurately translate information provided on contracts, credentialing attestations and other sources to maintain provider records.
Math skills to compile and validate statistical computations, reconcile discrepancies, and insure the validity and accuracy of results.
Knowledge and application of English grammar including composition, editing and proofreading skills.
Basic organizational/time management and project management skills and multi-tasking abilities.
Detail oriented with analytical and problem solving skills. Knowledge of health care industry issues preferred.
Ability to accurately enter relevant information into the credentialing system and other ancillary data repositories as needed.
Must be able to understand fairly complex written and oral instructions.
Ability to clearly present written information and findings. Ability to communicate concepts.
Ability to interact well with co-workers and outside contacts.
PC literacy; MSOffice skills (competency in Word, advanced skill in Excel, Access and other database applications).
Regularly required to work standard office equipment (personal computer, photocopy machine, fax machine, etc.).
Ability to work on a computer up to 7 hours a day.
Regularly required to sit for long periods of time, and occasionally stand and walk.
Regularly required to use hands to operate computer and other office equipment.
Close vision required for computer usage.

Required Skills:
Shift: 8:00am-4:45pm EST (could start as late as 9am if needed)
Resource will be working off of their own personal equipment. (no MacBook/no Chromebook)
Resource must be local to the Alpharetta, GA or Camp Hill, PA office. Though the role is remote, the is a potential opportunity to go onsite at a future time.

Notes on what the Manager is looking for in the applicants experience:
- High attention to detail working in a production environment
- Strong data entry skills
- Must have experience working in the healthcare/dental/insurance industry
- Resource MUST have two monitors to be successful in this position