Credentialing Specialist - Dental Network

Credentialing Specialist (Dental Network)

We are seeking an experienced Credentialing Specialist to support our client in Evansville, IN or Toledo, OH! Job Type: 13-Week Contract | Onsite Schedule: Day Shift 5x8s 8:00 AM 4:30 PM No on-call or weekends

Overview: This role manages provider data, verifies documentation, and ensures compliance with credentialing standards and regulatory requirements. The position also supports provider directory maintenance and network reporting.

Key Responsibilities:

• Coordinate initial credentialing and re-credentialing for network dentists
• Verify credentials through primary sources including CAQH and NPDB
• Maintain accurate provider records including licensure, DEA, malpractice coverage, and claims history
• Track credentialing documentation and maintain audit trails
• Prepare credentialing documentation for leadership approval
• Manage provider contracts and fee schedules
• Maintain and update Commercial and Medicare provider directories
• Upload updated directories to health plans monthly
• Run provider adequacy and accessibility reports
• Process provider updates and notify providers upon completion
• Support accounting with TIN verification as needed
• Assist with provider termination notifications to members
• Serve as a point of contact for provider offices and leased network partners

Qualifications:

• Must have at least 1+ years of credentialing experience (medical or provider experience accepted)
• Must be tech savvy with credentialing software and Excel
• Must have HS Diploma or GED
• Prior insurance industry knowledge and familiarity with terminology is preferred

Additional Details:

• Business casual dress code (back-office setting)
• Free parking
• Assignment may extend depending on coverage needs
• Potential for temp-to-perm, though not guaranteed
• Health Requirements: COVID-19 vaccination required (medical/religious exemptions accepted) Flu vaccination required (medical/religious exemptions accepted)