When it comes to making a meaningful difference in the lives of our customers and employees, USAble Life (a Life & Specialty Ventures Company) is always ready.

At USAble Life, we strive to have a positive impact in the lives of others, especially our employees. We are a diverse group of individuals working together to go the extra mile. Bring your talents and expertise to join our team, and you’ll be rewarded with opportunities for personal and professional development. Our passion for delivering the best products is matched by our passion for our people.

USAble Life has made Arkansas Business Magazine’s list of “Best Places to Work” for an impressive fifth consecutive year in a row! This, coupled with our engaging culture and a comprehensive benefits package, ensures we are committed to our employees.

Life Takes You Places! Are you ready to join us?

Provider Data Maintenance & Credentialing Specialist I Overview:

• This position will be required to go into the Jacksonville office on a scheduled rotation.
• Conducts provider credentialing application and contract package review prior to processing
• Performs timely data entry of provider application information and contract arrangements into administrative system
• Prepares adverse files for review by the Dental Credentialing Committee. Updates and maintains contract and demographic information on participating provider
• Generates correspondence to providers confirming contract or demographic changes, credentialing status, and requests for missing or incomplete information
• Provides general assistance with projects as required

Essential Duties:

• Enters credentialing and re-credentialing applications into the administration systems
• Conducts follow-up as necessary with Credentialing Verification Organization to obtain completed Primary Source Verification credentialing report in a timely manner
• Communicates with providers regarding missing information from credentialing files and requests additional information from external agencies
• Reviews credentialing reports loaded into the administration system for accuracy
• Performs timely data entry of contract arrangements into administration system following credentialing
• Updates and maintains contract and demographic changes ensuring accurate reporting, claims payment and directory information. Ensures timely follow-up is conducted to secure missing information
• Generates letters to providers following contract or demographic maintenance
• Meets or exceed departmental and individual metrics goal expectations as required by productivity and quality
• Prepares documents for contract execution
• Processes adverse files including researching information with appropriate agencies
• Prepares adverse reports for review by the Dental Credentialing Committee
• Performs telephonic and written correspondence outreach to providers for any missing, expired or incomplete documentation
• May perform other duties as assigned

Required Knowledge, Skills, and Abilities:

• Knowledge in the health or dental insurance industry
• Excellent communication skills including the ability to address a wide range of audiences
• Customer service skills
• Basic MS Office skills
• Ability to read documents and extract information
• Ability to understand and evaluate contractual language
• Ability to work within time constraints and maintain attention to detail
• Ability to prioritize work flow and work independently but coordinate efforts within a team

Required Education and Experience:

• High School Diploma or equivalent
• 2- 4 years experience in the health or dental insurance industry

Preferred Education and Experience:

• Associate's Degree
• Experience in provider credentialing or contracting. Experience evaluating and loading insurance contracts. Dental insurance industry background. Knowledge of credentialing and contracting database and delegated claims system is preferred

USAble Life employees are required to be fully vaccinated against COVID-19 as a condition of employment, unless an employee qualifies for an exemption. This requirement applies regardless of work location. The Centers for Disease Control and Prevention (CDC) defines people as “fully vaccinated” for COVID-19 two weeks after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna), or two weeks after they have received a single-dose vaccine (Johnson & Johnson [J&J]/Janssen).

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