The Senior Credentialing and Insurance Specialist will be the in-house insurance expert on plan details, provider credentialing and provider licensure. The Senior Credentialing and Insurance Specialist will impact results by delivering the Espire mission to team members and patients by living joyfully, leading bravely, and creating greatness.
Manage all insurance payor relationships
Provide strategic analysis on insurance plan utilization
Ensure all providers are appropriately credentialed
Manage all provider malpractice enrollment
Track all provider licensure
Input all fee schedules
Provide support on local market fee analysis
RCM functions including but not limited to, insurance plan strategy, claims management, insurance payment posting, verifications, and aging reports
High school diploma or GED, required
Bachelor’s Degree in Business or related field, or equivalent experience, preferred
Expert level knowledge in dental insurance
Proactive problem solving
Analytical approach to providing recommendations
Strong organizational skills
Understanding of compliance and regulatory standards pertinent to scope of activities of job
Ability to work in a team environment required
Excellent coaching skills
Level 1
: A combination of sitting, standing and walking with little requirement for physical effort. There may be a requirement to exert light physical effort for short periods.
No supervisory responsibility.
1% - 10% travel required.
