Credentialing Manager
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Job Description
Credentialing Manager managing dental payer enrollment for a growing Dental Support Organization. Ensure accurate, efficient, and timely credentialing across multiple practices and payers.
Responsibilities:
- 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
- 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
Requirements:
- 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
- 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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