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Credentialing Manager

Key Facts

Remote From: 
Full time
Mid-level (2-5 years)
English

Other Skills

  • Ability To Meet Deadlines
  • People Management
  • Communication
  • Time Management
  • Organizational Skills
  • Detail Oriented
  • Relationship Management

Roles & Responsibilities

  • Minimum 3 years of dental credentialing experience, preferably within a DSO or multi-location group
  • Proven experience credentialing with major dental PPOs, Medicaid plans, and TPAs
  • Strong understanding of dental payer requirements, timelines, and enrollment processes
  • Experience managing credentialing for multiple providers and locations simultaneously

Requirements:

  • Oversee end-to-end provider credentialing and re-credentialing for dentists within Medicaid and commercial networks
  • Manage payer enrollments, TIN updates, and provider records ensuring accuracy, compliance, and timely reimbursement
  • Support fee schedule negotiations, ensuring correct fee schedules are maintained with all contracted payers
  • Maintain accurate credentialing records, CAQH profiles, and payer portals

Job description

Position: Credentialing Manager
Location: Remote
Department: Revenue Cycle
Reports To: Director of RCM
 
Position Overview:
• Lead and manage provider credentialing and payer enrollment for a growing Dental Support Organization (DSO)
• Ensure accurate, efficient, and timely credentialing to support revenue continuity across multiple practices and payers
• Manage dental insurance credentialing and DSO-scale operations
• Proactively handle payer relationships, timelines, and compliance requirements
 
Key Responsibilities:
• Oversee end-to-end provider credentialing and re-credentialing for dentists within Medicaid and commercial networks
• Manage payer enrollments, TIN updates, and provider records ensuring accuracy, compliance, and timely reimbursement
• Support fee schedule negotiations, ensuring correct fee schedules are maintained with all contracted payers
• Maintain accurate credentialing records, CAQH profiles, and payer portals
• Act as the primary liaison between practices, payers, and internal RCM teams for credentialing functions
• Track credentialing status, deadlines, and expirations; proactively resolve issues
• Develop and maintain credentialing workflows, standard operating procedures (SOPs), and tracking tools
• Identify opportunities to improve turnaround times, reduce denials, and enhance payer communication
 
Required Qualifications:
• Minimum 3 years of dental credentialing experience, preferably within a DSO or multi-location group
• Proven experience credentialing with major dental PPOs, Medicaid plans, and TPAs
• Strong understanding of dental payer requirements, timelines, and enrollment processes
• Experience managing credentialing for multiple providers and locations simultaneously
• High attention to detail with excellent organizational and follow-up skills
• Proficiency with credentialing databases, payer portals, and Excel-based tracking
• Ability to work independently in a fast-paced, high-volume environment
Preferred Qualifications:
• Familiarity with dental revenue cycle management (RCM) workflows and downstream revenue impacts
• Prior experience in people management or vendor oversight
• Knowledge of Denticon, Open Dental, Eaglesoft, or similar dental practice management systems (PMS)

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