Delegated Credentialing Specialist
On-siteCarrollton, Texas, United States
Job Summary
Coordinate credentialing and recredentialing for dentists and specialists in delegated payer networks by reviewing applications for completeness and accuracy. Complete primary source verification for licenses, DEA registrations, education, work history, and malpractice records. Prepare files for clean-file approval, special review, and Credentialing Committee decisions while identifying and escalating red-flag findings such as sanctions or exclusions. Maintain accurate provider records in the credentialing platform and monitor expirables including licenses, certifications, and attestations. Support delegation audits through file reviews, documentation requests, and corrective action follow-up. This role ensures providers are credentialed in accordance with payer requirements and MB2 Dental policies while supporting timely onboarding and uninterrupted revenue generation.
Required Qualifications
- Minimum of 2 years of healthcare credentialing experience
- Working knowledge of credentialing principles
- Working knowledge of primary source verification
- Working knowledge of provider lifecycle management
- Working knowledge of compliance documentation
- Strong organizational skills
- Ability to prioritize work
- Ability to meet deadlines
- Ability to maintain accuracy in a high-volume environment
- Strong written and verbal communication skills
- Ability to work effectively with internal teams
- Ability to work effectively with providers
- Ability to work effectively with practices
- Ability to work effectively with payer contacts
- Ability to handle confidential information
- Professionalism
- Sound judgment
Desired Qualifications
- Experience using Credential Stream
- Experience using a comparable credentialing platform
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