Associate Credentialing Representative

TL;DR

Associate Credentialing Representative: Processing provider applications and re-applications for dental networks with an accent on data accuracy, database maintenance, and regulatory compliance. Focus on managing credentialing inventory, coordinating verifications, and supporting system implementations to ensure seamless provider enrollment.

Location: Must be based in Pennsylvania

Company

hirify.global is a national health and wellness organization providing health insurance and related services.

What you will do

• Process provider applications and re-applications including initial mailing, review, and data entry.
• Maintain and update provider information in the dental provider file database.
• Communicate with providers via phone and mail regarding credentialing status and requirements.
• Coordinate credentialing verifications and manage inventory to meet established timelines.
• Support the implementation of new networks, systems, and software guidelines.
• Participate in projects aimed at streamlining and automating credentialing functions.

Requirements

• Must be based in Pennsylvania
• High School Diploma or GED required.
• 0-1 years of relevant experience in provider data management, customer service, or claims.
• Proficiency in Microsoft Office suite (Word, Excel, PowerPoint).
• Strong written and verbal communication skills.
• Ability to maintain professional demeanor when interacting with provider offices and internal committees.

Nice to have

• Familiarity with credentialing processes and URAC standards.
• Experience with ULTRA and Dental Provider File systems.
• Background in customer service inquiry systems or claims processing concepts.

Culture & Benefits

• Adherence to high ethical and legal standards including HIPAA compliance.
• Opportunity to work in a structured corporate environment with clear compliance guidelines.
• Focus on professional development and subject matter expertise within the credentialing department.