Credentialing and Insurance Specialist - Dental Clinic

Credentialing and Insurance Specialist - Dental Clinic

Shift : 8am-5 : 00pm / Monday-Friday / Possible Hybrid

Status : Full Time / 40hr week

Location : Akron Campus Center for Dental Health

Summa Health System is recognized as one of the region’s top employers by a number of third party organizations, including NorthCoast 99.

Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits.

Summary :

This position serves as a liaison between the Dental Clinic providers, including residents, and payers, the hospital, and patients.

This role’s responsibilities include hospital and payer privileging, credentialing and enrollment, to ensure compliant revenue cycle activities.

Additionally, this role serves as the gatekeeper for payer information and maintains accurate records and repositories of effective dates, contracted payers, and plan information..

Formal Education Required

• High school diploma or equivalent
• Associate Degree preferred

Experience & Training Required

• Three (3) years’ experience in provider credentialing, managed care, physician office, and / or other healthcare-related environment to include experience with dental insurance verification, front-desk registration duties or related medical office roles, and experience working with an Electronic Health Record (EHR) system.
• Working knowledge of dental / medical billing procedures, computers, calculators, and other equipment used in Financial Services.

Other Skills, Competencies and Qualifications

• Knowledge of medical or dental terminology and CDT codes.
• Demonstrated understanding of the variations in insurance plans and requirements.
• Ability to solve practical problems, interpret a variety of instructions furnished in written, oral, diagram or schedule form and to work reliably and with professionalism in a high-volume, high demand medical environment.
• Proficiency in Microsoft Word, Microsoft Excel, and e-mail. Prefer skills in using health plan web sites.
• Excellent organizational and communication skills.
• Ability to work independently and productively as part of a team to reach decisions and solve problems
• Good analytical skills necessary for problem solving.
• Ability to maintain confidentiality of patient, employee, and financial information.
• Ability to interact with populations of patients with an understanding for their needs of self-respect and dignity.

Level of Physical Demand

Exerts up to ten pounds of force occasionally and / or a negligible amount of force frequently.

$21.33 / hr - $25.60 / hr

The salary range on this job posting / advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay.

We believe in the importance of pay equity and consider internal equity of our current team members when determining offers.

Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.