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Delta Dental Credentialing Administrator in Okemos, Michigan

div class="contentHead" data-ng-bind-html="field.label | trustAsHtml"Description/divdiv class="content" data-ng-bind-html="field.content | trustAsHtml"Job Summary: Administers all aspects of the credentialing/re-credentialing program.Primary Job Responsibilities1. Administrator of the credentialing process, which includes credentialing and re-credentialing of Tristate and North Carolina providers.2. Serves as National Provider File (NPF) Coordinator to the DDPA, and provides internal support and resolves all National Provider File (NPF) data issues.3. Researches adverse actions against providers to include disciplinary actions, malpractice, legal issues or sanctions, and handles resulting mailings and correspondence on Committee actions.4. Maintains all records for internal and external audits of the credentialing program (DDPA, ISO, SSAE-16, lapsed license, DDPA IRS) and is the liaison for department audits.5. Modifies and maintains requirements in the provider system including Tristate/North Carolina disciplinary actions, sanctions, garnishments and levies.6. Trains and directs internal and external customers on credentialing and provider records issues.span class="ai_BEaTUW6Eqb3ix4L5_2"span class="a4_BEaTUW6Eqb3ix4L5_2"Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above./span/span/div

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