Dental Credentialing Specialist: Compliance & Provider Data

sgadental; Claxton (GA); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Paid holidays

PTO

401(k) Retirement Plan

Health and Vision Insurance

Employer-Paid Dental Insurance

Life Insurance

Care.com Membership & EAP

Disability coverage

Career growth opportunities

Job summary

SGA Dental Partners is seeking a Credentialing Specialist to manage end-to-end credentialing for dental providers, ensuring accurate records, compliance with plan requirements, and timely application processing across networks.

You will maintain provider records, monitor licenses and certifications, and communicate status updates to offices and management, while safeguarding confidentiality and supporting quality initiatives within a collaborative dental practice network.

Qualifications

• Associate degree preferred in healthcare administration or related field.
• 1–3 years of medical/dental credentialing experience ideal.
• Strong understanding of insurance payor processes and provider data management.

Responsibilities

• Manage end-to-end credentialing and recredentialing of dentists/providers, including applications, follow-ups, and timely completion of all requirements.
• Maintain accurate, up-to-date provider and office records across credentialing databases, systems, and network participation listings.
• Track and manage expirations for licenses, certifications, and required documents; ensure timely renewals and compliance.
• Maintain and organize all credentialing documentation, including state licenses, certifications, and supporting materials.
• Monitor credentialing timelines and proactively communicate status updates to offices, providers, and management.
• Manage recredentialing communications, including tracking and responding to incoming requests and managing any discrepancy resolutions.
• Ensure provider demographic, billing, and practice information is accurate and current with dental plans and relevant entities.
• Stay current on dental plan requirements, regulatory standards, and industry trends impacting credentialing.
• Provide administrative support for credentialing, network participation, and specialty service operations.
• Resolve incoming inquiries and insurance plan discrepancies related to credentialing and provider status.
• Maintain strict confidentiality of provider and patient information and ensure full compliance with HIPAA regulations.
• Support continuous quality improvement initiatives and adhere to company policies and procedures.
• Perform additional administrative or operational duties as assigned

Skills

MS Excel

Practice Management software

Attention to detail

HIPAA compliance

Education

Associate Degree preferred

Tools

Practice Management software

EHR systems

Job description

SGA Dental Partners is seeking a Credentialing Specialist to manage end-to-end credentialing for dental providers, ensuring accurate records, compliance with plan requirements, and timely application processing across networks.

You will maintain provider records, monitor licenses and certifications, and communicate status updates to offices and management, while safeguarding confidentiality and supporting quality initiatives within a collaborative dental practice network.