Payor Audit & Enrollment Specialist

The Specialist – Payor Audit & Provider Enrollment serves as the organization's subject-matter expert for payor audit response, delegated credentialing oversight, and provider enrollment data integrity. This role manages payor-initiated audits from intake through resolution, determining response strategy and authoring formal responses on behalf of the organization; leads delegated credentialing audits and maintains continuous audit readiness against payor and accreditation standards; and governs provider enrollment and billing data within DentalXchange and connected systems. Working under general direction, the Specialist interprets payor contracts, delegation agreements, and regulatory requirements, exercises