Dental Network Specialist

Biz. Tek People is in search for an experienced Dental Network Specialist for our client in Evansville, IN!

Job Summary

The Credentialing Specialist is responsible for coordinating initial credentialing and re-credentialing applications for network dentists in accordance with organizational standards and regulatory requirements. This role also manages provider data, network updates, and provider directories.

Key Responsibilities

Coordinate initial credentialing for 12–16 new providers per month (volume may vary weekly) Manage re-credentialing of providers on a three-year cycle Gather, verify, and maintain documentation in accordance with credentialing policies and procedures Perform primary source verification, including licensure, DEA certificates, malpractice coverage, claims history, CAQH, and National Practitioner Data Bank (NPDB) review Maintain accurate provider files and audit trails Prepare completed credentialing files for leadership review and signature Set up providers in the internal system Pull reports and data for monthly sanction meetings Run quarterly provider adequacy and accessibility reports Maintain and update Commercial and Medicare provider directories Upload provider directories to Medicare and health plans monthly Process provider updates and terminations, including member notifications Manage provider contracts and fee schedules Complete network verifications to meet state requirements Support accounting with TIN verification as needed Serve as a primary contact for provider offices and leased networks Coordinate reporting and provider data requests with external network partners Qualifications Minimum of 3+ years of provider credentialing experience Strong working knowledge of credentialing standards and regulatory requirements Experience with CAQH and NPDB required Tech-savvy with credentialing systems and proficient in Microsoft Excel Prior insurance industry experience and familiarity with industry terminology High School Diploma or GED required Strong attention to detail and organizational skills Additional Details Fully onsite position Business casual dress code (back-office setting) No parking fees 13-week assignment with potential extension based on coverage needs #Credentialing.

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