Expirations & Data Integrity Specialist, Dental Insurance Administration- Remote
Heartland Dental is looking to expand our team! The Expirations & Data Integrity Specialist serves as a subject matter expert responsible for ensuring the integrity, accuracy, regulatory compliance, and ongoing maintenance of provider credentialing data across all delegated credentialing programs. This role is responsible for monitoring provider credential expirations, conducting data governance activities, mitigating compliance risks, maintaining credentialing system accuracy, and driving continuous process improvement initiatives.
The Specialist partners with internal stakeholders, supported offices, providers, payors, credentialing vendors, and compliance teams to ensure provider information remains accurate, current, and compliant with NCQA, CMS, state regulatory, delegated entity, and payor requirements.
This position serves as a critical control function protecting provider participation, reimbursement, delegated credentialing compliance, and organizational readiness for audits. The position only supports dental providers, Hygienists and Dental Assistants are not included.
The position reports to the Delegated Credentialing Supervisor and is a fully remote position based out of Effingham, IL.
With more than 1,900+ dental offices supported across 39 states, over 20,000 team members and over 3,100 supported doctors, Heartland Dental has a proven track record of growth and success. We’re looking for professional individuals who are open, positive and mentally flexible to join our network of support.
Minimum Requirements:
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Detail-oriented with strong organizational skills
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Proficient in Microsoft Office and reporting systems
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Excellent communication and customer service skills
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Strong multitasking, prioritization, and problem-solving abilities
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Self-motivated with good judgment and initiative
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Process improvement mindset with an interest in leveraging technology and automation to drive efficiency and growth
Preferred Requirements:
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Advanced Microsoft Excel skills, including Pivot Tables, VLOOKUP/XLOOKUP, Power Bi, and data analysis.
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Experience developing and maintaining operational dashboards and reports to monitor key performance indicators, compliance metrics, workflow trends, and departmental performance.
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Experience working with NCQA standards, delegated credentialing requirements, provider licensing requirements, and regulatory compliance.
- Experience utilizing credentialing software, provider databases, and reporting tools.
Physical Requirements:
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Ability to perform essential duties satisfactorily with or without reasonable accommodation. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties of the position
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Prolonged periods sitting at a desk and working on a computer
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Must be able to lift up to 15 pounds at times
We put our people first at Heartland Dental, and that shows in our generous benefits package.
Company retains the sole discretion to change the duties of the position at any time.
We provide all employees and applicants for employment in the protections of federal, state, and local laws affording equal opportunity in employment.
