Dental Credentialing & EFT Specialist (Remote)

DECA Dental Group; Dallas (TX); Hybrid; USD 36,000 - 39,000; Full time

Benefits offered by this job

Remote or hybrid work options

Job summary

DECA Dental Group is seeking a Dental Credentialing Specialist to manage the full credentialing and recredentialing lifecycle for dental providers across multiple payers. You will enroll providers and locations in EFT programs and support new location NPI setup, including Type 2 NPIs.

You will maintain credentialing data, track applications, respond to payer inquiries, ensure NCQA/CMS compliance, and collaborate with Operations, HR, Revenue Cycle and IT to onboard providers and locations.

Qualifications

• High school diploma or equivalent.
• 5+ years of healthcare or dental credentialing experience.
• Familiarity with Delegated, CAQH, NPPES, PECOS and payer portals.
• Experience submitting and maintaining NPI records (Type 1 and Type 2).
• Knowledge of dental insurance plans (PPO, DHMO, Medicaid, Medicare Advantage).
• Excellent attention to detail and organizational skills.
• Proficiency in Microsoft Office.

Responsibilities

• Manage initial credentialing and recredentialing for dental providers with multiple payers.
• Maintain credentialing database, ensuring accuracy of provider info, licenses, and certifications.
• Track and follow up on submitted applications for timely approvals.
• Respond to credentialing inquiries from payers and internal teams.
• Serve as primary contact for DECA’s CVO partner.
• Facilitate creation/registration of Type 2 NPIs for new locations.
• Coordinate with operations, HR, IT to gather data for NPI submissions.
• Maintain documentation for all NPI records.
• Initiate and complete EFT enrollment for providers and locations.
• Ensure secure collection and submission of banking information.
• Monitor compliance with NCQA, CMS, and payer guidelines.
• Assist with payer audits and internal credentialing reviews.
• Collaborate with Operations, HR, Revenue Cycle and IT on onboarding.

Skills

Attention to detail

Organizational skills

Microsoft Office

Education

High school diploma

Tools

Denticon

Job description

DECA Dental Group is seeking a Dental Credentialing Specialist to manage the full credentialing and recredentialing lifecycle for dental providers across multiple payers. You will enroll providers and locations in EFT programs and support new location NPI setup, including Type 2 NPIs.

You will maintain credentialing data, track applications, respond to payer inquiries, ensure NCQA/CMS compliance, and collaborate with Operations, HR, Revenue Cycle and IT to onboard providers and locations.