Medical/Dental Contracting and Credentialing Specialist
- Hiring from
- United States
- Work type
- Remote
- Posted
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Benefits:
- Flexible schedule
About Triton Medical Solutions
Triton Medical Solutions is a medical billing and revenue cycle management company based in Tempe, Arizona. Since 2011, we have supported dental, orofacial pain, TMJ, dental sleep medicine, and CBCT radiology providers nationwide with specialized medical billing and practice support services.
We are committed to helping healthcare practices navigate the complexities of medical insurance billing, credentialing, and revenue cycle management while delivering accurate, dependable, and personalized service.
About the Position
We are seeking an experienced Medical/Dental Contracting and Credentialing Specialist with a strong background in healthcare provider enrollment, insurance network contracting, and credentialing. This is a part-time, remote Independent Contractor position requiring approximately 20 hours per week.
This position is responsible for managing the contracting and credentialing process for healthcare providers seeking participation with medical insurance networks. The ideal candidate will have hands-on experience submitting and monitoring provider applications, communicating with insurance carriers, maintaining CAQH profiles, and ensuring provider information and credentialing records remain accurate and up to date.
We are looking for a detail-oriented professional who understands the complexities of insurance contracting and credentialing and can independently manage multiple provider applications and follow-ups.
What you will do
- Process and manage initial provider credentialing, recredentialing, and insurance network contracting applications.
- Submit applications and supporting documentation to insurance carriers and health plans to establish or maintain in-network provider status.
- Communicate with insurance companies, healthcare providers, medical and dental office staff, and licensing agencies to obtain required information and resolve application issues.
- Monitor application status and follow up with insurance carriers to ensure timely processing and completion.
- Maintain and update provider credentialing and contracting records, including electronic databases and provider files.
- Complete primary source verifications and other required credentialing verifications.
- Register, maintain, and regularly update provider information in CAQH.
- Ensure provider credentials, licenses, certifications, and other required documentation remain current.
- Understand applicable state and federal regulations and accreditation requirements related to credentialing.
- Respond to internal and external requests for provider credentialing and contracting information.
- Maintain accurate records of provider participation, effective dates, network status, and demographic changes.
- Prepare and distribute credentialing reminders and regularly scheduled reports.
- Serve as the primary point of contact for credentialing and contracting-related matters.
- Perform other duties as assigned.
What we are looking for
- Previous healthcare insurance contracting and provider credentialing experience required.
- Hands-on experience with medical and/or dental provider enrollment and insurance network applications.
- Experience working directly with insurance carriers and health plans.
- Familiarity with CAQH, provider enrollment, recredentialing, and primary source verification.
- Certified Provider Credentialing Specialist (CPCS) certification preferred.
- Knowledge of state and federal credentialing regulations and AAAHC accreditation standards preferred.
- Ability to maintain confidential provider credentialing files and electronic databases.
- Demonstrates a high level of professionalism and discretion when handling confidential information.
- Excellent organization, time management, problem-solving, and attention to detail.
- Self-directed work habits, accountability, and the ability to work independently while managing priorities.
- A dedicated workspace, reliable computer, printer, and high-speed internet connection.
Expectations
- As an Independent Contractor, you will use your own equipment that meets Triton’s IT and security requirements. You are expected to maintain confidentiality, uphold accuracy standards, and manage your daily tasks independently while supporting assigned client accounts.
Position Details
- Classification: Part-time Independent Contractor
- Work arrangement: Remote
- Hours: Approximately 20 per week
- Schedule: Flexible scheduling, subject to agreed-upon work requirements and deadlines.
This is a remote position.
About Us
Located in Tempe Arizona, Triton Medical Solutions was founded on the principle that innovative medical billing solutions free dental and medical professionals to concentrate on their prospective fields of medicine, rather than fighting with insurance companies.
