Provider Enrollment Support Coordinator (Dentaquest) Remote

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.
DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all.
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Provider Enrollment Specialist primary responsibilities include receiving provider credentialing documents, pre-screening for completeness, scanning and re-routing. This permits accurate and timely processing of credentialing documents. This role also includes reviewing, scanning, filing and coordinating the execution of provider agreements. The intake review specialist enters provider data pertaining to applications, contract information, status changes, and payee changes.
(heading) / Description Du Poste (titre)

• Provider Enrollment Specialist primary responsibilities include receiving provider credentialing documents, pre-screening for completeness, scanning and re-routing. This permits accurate and timely processing of credentialing documents. This role also includes reviewing, scanning, filing and coordinating the execution of provider agreements. The intake review specialist enters provider data pertaining to applications, contract information, status changes, and payee changes.

Preferred Skills (heading) / Compétences Particulières (titre)

• Proficiency in the use of Cactus credentialing software preferred.
• Associate degree preferred.
• Experience in credentialing preferred.

Qualifications (heading) / Compétences (titre)

• 2 years of experience in business environment.
• Ability to adapt to constantly changing environment.
• Proficient in the use of Excel.
• Required to attend additional training as requested/deemed necessary.
• Ability to create status reports on metrics.
• Attention to detail.
• Ability to analyze data to determine next steps.
• Proficient in general computer software (Word, Outlook, PowerPoint).
• Ability to remain organized amid multiple interruptions.
• High School diploma or equivalent
• Ability to make independent decisions.
• Excellent customer service skills.
• Ability to work in excess of 40 hours.
• Ability to prioritize and organize multiple tasks.
• Excellent verbal and written communication skills.
• Ability to work in a fast paced environment.
• Ability to learn new software programs quickly.

Responsibilities (heading) / Responsabilités (titre)

• Conduct review of assigned provider enrollment documents daily.
• Follow up with providers to ensure that all necessary information is received and that the enrollment process is completed timely.
• Other duties as needed or required.
• Receive assigned mail relating to provider enrollment daily and turn electronic.
• Stamp all enrollment documents assigned daily.
• Electronically file provider contracts.
• Develop relationships with providers and their staff and answer questions they may have about the process.
• Research and correct data to avoid duplicate provider, locations or payees.
• Scan provider contracts.
• Work with providers by phone, fax, U.S. mail, and email to ensure that they complete the enrollment process.
• Coordinate scanning of documents and store electronically to Cactus credentialing software.
• Audit provider contract effective dates for execution.
• Process assigned provider enrollment documents daily.
• Coordinate contract execution.
• Electronically review assigned faxes and emails daily.
• Conduct review of assigned provider enrollment documents daily.
• Research for active records in enterprise system.
• Enter or update existing provider records in enterprise system.
• Re-direct non-credentialing documents daily.
• Track daily intake volumes.

Our Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email [email protected] to request an accommodation.
At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.
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Job Category:
Administrative Services
Posting End Date:
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran