Credentialing Specialist

Specialized Dental Partners; Franklin (TN); On-site; USD 45,000 - 55,000; Full time

Job summary

The Credentialing Specialist (Revenue Cycle) at Specialized Dental Partners will support insurance payor relationships, provider credentialing and enrollments across our network of dental practices. The role aims to establish stronger payer positions and ensure timely credentialing activities in multiple markets.

Responsibilities include collaborating with practices, maintaining payor files, completing applications, and addressing enrollment-related issues.

Qualifications

• High school diploma or GED required.
• 2+ years in a Dental practice or DSO preferred.
• Experience with pivot tables and Excel formulas is essential.

Responsibilities

• Support overall relationship with insurance payors.
• Collaborate with practices to plan, strategize and support insurance payor credentialing needs.
• Manage provider credentialing and re-credentialing activities to minimize financial risk and coordinate onboarding with leadership.
• Maintain provider files and payor participation information, including expirable documents.
• Complete all payor credentialing applications and obtain documents as needed.
• Identify and resolve enrollment-related underpayments or non-payments in a timely manner.
• Develop SOPs, training, and onboarding materials for payor contracts.
• Coordinate with Practice Support Services and practice-based teams.
• Perform other duties as assigned.

Skills

Pivot tables

V-lookups

Excel formulas

Fee schedule analysis

CAQH & NPI management

Data management systems

Insurance networks

Education

High school diploma or GED

Tools

Microsoft Excel

Job description

Overview

About Specialized Dental Partners:

Specialized Dental Partners is a doctor-led network of 275+ specialty dental practices and 450+ doctors across multiple states. We offer the scale, resources, and professional connections that help specialists and teammates thrive, while maintaining the supportive culture and local relationships that define our organization.

Our purpose,We Care More, shapes how we support our doctors, teammates, and patients every day. We care more about patient outcomes, doctor success, teammate growth, meaningful relationships, and the communities we serve. By combining clinical excellence with a people-first culture, we create an environment where specialists can build rewarding careers while making a lasting impact.

At Specialized Dental Partners, you'll find more than a job. You'll find a community committed to helping you succeed.

From mentorship and career development to clinical collaboration and leadership opportunities, we are committed to helping our people grow personally and professionally.

If you're looking for an organization where your expertise is valued, your growth is supported, and your work makes a meaningful difference, we'd love to meet you!

Job Summary:

The Credentialing Specialist (Revenue Cycle) will serve to support all insurance payor relationships, including provider credentialing and enrollments, with the goal to establish stronger positions in markets represented by Specialized Dental Partners (SDP) in various dental specialties.

Responsibilities

• Serve to support overall relationship with insurance payors.
• Collaborate with practices to plan, strategize and support insurance payor credentialing needs.
• Support all provider credentialing and re-credentialing activities in a manner that mitigates the risk of financial losses, coordinate efforts with operational leaders through the on boarding process.
• Maintain provider files, payor participation information, including expirable documents.
• Complete all applications for payor credentialing and re-credentialing in a timely manner; obtain appropriate documents from various resources to complete payer applications, as needed.
• Assist to identify, and resolve timely, any payor enrollment-related under-payment / non payments.
• Assist to develop SOPs, training, and development of new colleagues on payor contracts.
• Communicate with other departments within the Practice Support Services, & practice-based teams,
• Other duties as assigned.

Qualifications

• High school diploma or GED
• 2+ years of experience working in a Dental practice or a DSO
• 2+ years of experience creating pivot tables, using V-lookups, and formulas in Microsoft Excel
• 2+ years of experience doing fee schedule analysis
• 2+ years of experience in CAQH and NPI management
• 2+ years of experience working in data management systems and insurance networks

Specialized Dental Partners, its affiliates, related companies andindependently owned supported clinical practicesare proud to be Equal Opportunity Employers. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

The salary range for this role is $45,000 - $55,000 per year. At Specialized Dental Partners, its affiliates, related companies and independently owned supported clinical practices, we are committed to ensuring fair and equitable pay for all employees. We adhere to all applicable federal, state, and local laws regarding pay equity and non-discrimination. Our compensation practices are designed to ensure that employees are paid fairly based on their role, experience, performance, and contributions to the company, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. We regularly review our compensation practices and conduct pay equity audits to identify and address any disparities. By fostering a culture of transparency and fairness, we aim to create an inclusive workplace where all employees feel valued and respected.