Credentialing Specialist: Payer Relations & Enrollment

Specialized Dental Partners

Franklin (TN)

On-site

USD 45,000 - 55,000

Full time

5 days ago

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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.