Careington Career:
Claims Specialist

JOB DETAILS APPLY NOW

Duties & Responsibilities:

  • Use mail, e-mail, fax and phone to communicate with provider's offices and credential dentists
  • Follow Careington's Policies and Procedures for credentialing dentists
  • Review and analyze dentists applications and accompanying documents, ensuring applicant eligibility
  • Conduct thorough investigation, research and primary source verification of all components of the dentist file; submit and retrieve National Practitioner Database reports
  • Create and maintain files on providers
  • Correctly enter contracts and maintain quality of data entered
  • Process provider changes and cancels
  • Meet monthly minimum production standards
  • Assist in scanning and archiving documents
  • Assist with credentialing audits and conduct internal file audits.
  • Look for efficiencies in current processes
  • Assist in various Credentialing and ND department projects
  • Perform other related duties as required and assigned

Knowledge, Skills & Abilities:

  • Must be accurate and detail-oriented, with strong organizational skills
  • Ability to communicate clearly, both orally and in writing
  • Professional phone manner with the ability to build strong provider relationships
  • Must possess a positive attitude and want to be part of a team environment
  • Self-motivated with the ability to work independently with minimal supervision
  • Ability to manage time and duties efficiently
  • This position requires regular, predictable attendance and the ability to adhere to all of Careington's work rules, policies and procedures

Education, Experience & Software:

  • High school diploma or equivalent; college degree preferred but not required
  • Must have at least 1-2 years of clerical office experience; previous credentialing experience a plus
  • Good computer skills and experience with MS Applications - Excel, Word, Outlook, etc

Summary

  • Under supervision of the Network Credentialing Manager, the Credentialing Specialist will credential and re-credential dentists into our provider network and assist with departmental projects. The work schedule for this position 8-5 Monday - Friday or 8-6 Monday - Thursday & 8-12 on Friday

Ready to apply?


If you are interested in this position, click the button below to send us your resume with the job title as the subject line.

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Company information

Careington International Corporation
Attention: HR Department
7400 Gaylord Parkway
Frisco, Texas 75034
Email: [email protected]


Please note:

For immediate consideration, please email your resume along with your salary requirements.

No phone calls and no agencies please. Careington is an equal opportunity employer.

DISCLOSURES:
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance.
This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. This is not a Medicare prescription drug plan. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is at www.careington.com. A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034; phone 800-441-0380.

This plan is not available in Vermont or Washington.

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