Provider Administration Specialist

Builds positive relationships among health plans, providers, and practice managers while providing data entry and customer service support. Maintains the accuracy and integrity of provider information in enterprise systems and supports dental offices with provider updates.

Provider Administration Specialist


Job Summary

Maintains the accuracy and integrity of provider information in enterprise systems and supports dental offices with provider updates. Builds positive relationships among health plans, providers, and practice managers while providing data entry and customer service support.

Responsibilities

• Maintain provider information and electronic database records.
• Assist dental offices with business name, tax identification, contract, ownership, practice, associate, license, specialty, and directory updates.
• Plan, prioritize, organize, and complete work according to established objectives.
• Work independently or collaboratively to resolve complex provider servicing issues.
• Process workflow queues involving address and tax identification conflicts.
• Handle escalated calls from client groups and make outbound calls to dental offices.
• Resolve 1099 tax discrepancies by verifying information with external databases.
• Run queries and prepare monthly reports and credentialing document verification requests.
• Review provider enrollment packets for missing information and request required documentation.
• Provide technical support and assistance to team members as needed.
• Perform other related duties as assigned.

Requirements

• High school diploma or GED;equivalent relevant experience may be considered.
• At least two years of related experience, preferably in managed care or medical and dental insurance.
• Knowledge of dental terminology and Current Dental Terminology codes.
• Ability to type at least 40 words per minute with no more than two errors.
• Strong organizational, time management, multitasking, and problem-solving abilities.
• Strong written, verbal, interpersonal, and telephone communication skills.
• Strong attention to detail, mathematical ability, reading comprehension, and ability to follow complex instructions.
• Ability to work independently and collaboratively.
• Ability to promptly report technical issues and maintain clear communication until they are resolved.

Skill

• Provider data administration
• Data entry and database maintenance
• Customer service and telephone support
• Dental terminology and claims processing
• Report generation and data verification
• Problem-solving and conflict resolution
• Written and verbal communication
• Organization and time management

Summary Qualification

• Experience supporting providers, dental offices, or healthcare administration functions.
• Strong attention to detail when reviewing and updating records.
• Ability to manage multiple tasks and workflow queues accurately.
• Effective communicator who works well with internal teams and external contacts.
• Reliable, adaptable, and capable of handling sensitive provider and tax information.

 

Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.