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Credentialing Services Supervisor
Delta Dental of Arkansas. Oversee day-to-day operations of the Credentialing team .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in overseeing credentialing operations, ensuring compliance with NCQA and Delta Dental standards, and managing provider onboarding processes. Proficient in performance monitoring, process improvement, and team leadership within the dental insurance industry.
Highest-signal resume keywords
Credentialing StandardsNCQA CompliancePerformance MonitoringProcess ImprovementTeam Leadership
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Credentialing ProcessesProject ManagementAnalytical SkillsMicrosoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft PowerPointInsurance RegulationsERISA KnowledgeASO Agreements
Soft Skills
Customer ServiceRelationship BuildingProblem-SolvingVerbal CommunicationWritten Communication
Tools & Technologies
SymplrDDMI Provider Systems
Industry Keywords
Dental InsuranceProvider EnrollmentMedicare AdvantageMedicaidKPI Monitoring
About the role
Key responsibilities & impact- Oversee day-to-day operations of the Credentialing team
- Coordinate initial and ongoing compliance with NCQA and Delta Dental Plans Association standards, including the National Provider File
- Ensure Credentialing and provider onboarding functions follow department policies and procedures
- Work with provider services associates, providers, and external clients to ensure satisfaction and timeliness
- Generate performance measures and monitor performance against goals
- Coordinate with the Director of Compliance on departmental and company initiatives, performance guarantees, and operational targets
- Administer Symplr and DDMI provider systems
- Monitor KPIs and metrics for provider enrollment and credentialing effectiveness, efficiency, and compliance
- Lead continuous process improvement, standardized toolkits, training programs, and plan deployment
- Maintain contractual credentialing information for providers across all networks, including Medicare Advantage and Medicaid
- Run reports to identify and address outstanding applications, issues, and expiring information
- Monitor team production, quality metrics, workload distribution, and SMART goals
- Coordinate hiring and downstream training/support for new associates with HR
- Provide cross-departmental support for PR and claims activities
- Resolve issues and improve business processes with other departments
- Compile statistical information and distribute results to management
- Address provider credentialing concerns and escalate issues to the credentialing committee
- Manage NPF and other credentialing audits
- Serve as backup support for other credentialing team members
- Perform miscellaneous duties as assigned
Requirements
What you’ll need- Bachelor’s degree from an accredited college or university or equivalent experience
- Experience in the dental field preferred
- Supervisory experience preferred
- Working knowledge of state and federal insurance regulations, ERISA, and ASO agreements
- Working knowledge of credentialing standards and processes
- Understanding of dental insurance products and industry trends
- Proven customer service and relationship building skills
- Solid analytical and problem-solving skills
- Excellent verbal and written communication skills
- Proficiency in Microsoft Word, Excel, Outlook, and PowerPoint
- Process and project management experience required
- Ability to coach and support a cohesive team
- Must verify identity and eligibility to work in the United States
- Must complete the required employment eligibility verification form upon hire
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Vision insurance
- 401(k)
- Student loan assistance
- Six weeks of paid parental leave
- Volunteer PTO
- Collaborative, service-oriented, integrity-focused, and inclusive workplace culture