Payor Relations Specialist

The vision of Smile Doctors is our people-first culture which creates an environment of passionate, caring Team Members dedicated to providing fun and encouraging relationships with each other and our patients. Smile Doctors offers every Team Member the opportunity to be a part of something bigger. We focus on the importance of the individual and recognize that each person on our Team has something great to offer. We recognize talents and strengths and take care to nurture those abilities to help our Team Members grow into successful people in their careers, in our organization, and beyond.

We are looking for a Payor Relations Specialist to join our team.

If you are looking for an opportunity to be a part of a growing company and industry leader, Smile Doctors is the place for you. We operate the largest national network of orthodontic clinics with locations in more than 20 states.  At Smile Doctors, we excel at providing exceptional patient care.

What We Offer

• Competitive salary
• Medical, dental, vision and life insurance
• Short and long-term disability coverage
• 401(k) plan
• 3 weeks paid time off in your first year + paid holidays
• Discounts on braces and clear aligners for you and your family members

What You’ll Do

• Help manage all Credentialing Files: Manage internal and external provider credentials, maintain records of expired verification, and ensure the completeness of a file to perform verification of credentials.
• Complete and submit paperwork required for payor enrollment applications with in-network insurance plans. Responsible for verifying the correct forms are submitted timely for each payor.
• Completes provider re-credentialing applications for in-network payors, monitors applications, and follows up as needed.
• Communicate with Clinics and Payors: Be a first-line communicator with providers, practice directors, regional managers, payors and external verification sources and services, and internal teams.
• Maintain Data Integrity: Maintaining a current and accurate, system-wide data repository for provider information. This includes establishing and updating provider profiles and updating payor fee schedules and payor enrollment information within our databases.
• Assists in onboarding process for all new affiliations and associates.
• Notify payors of all doctors who leave Smile Doctors and notify payors of closed location.
• Compiles and maintains current and accurate data for all providers.
• Creates and maintains provider CAQH profiles
• Maintains copies of current state licenses, DEA licenses, malpractice coverage and any other required credentialing documents for all providers.
• Maintains insurance provider contract forms. Assists in the contracting process when going in-network with a new payor or new state.
• Tracks license, DEA license expirations, professional liability expirations, and certification expirations for all providers to ensure timely renewals.
• Ensures practice addresses are current with insurance payors.
• Maintains confidentiality of provider information.

What You’ll Need

• High school diploma or G.E.D.
• Two (2) years working with accounts receivables required, three (3) or more years preferred

This is the perfect opportunity to grow with an expanding organization! Apply today!

Smile Doctors and all our affiliating practices are proud to be an equal opportunity workplace and welcome diversity in our organization.  We do not discriminate against any team member or applicant for employment regardless of age, race, color, national origin, religion, disability, veteran status, sex, sexual orientation, or gender identity.