Dental Credentialing Specialist - Compliance & Provider Data

117090 SGA Dental Partners OPCO LLC; United States; On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

Paid Holidays and PTO

401(k) Retirement Plan

Health and Vision Insurance

Employer-Paid Dental Insurance

Life Insurance

Care.com Membership & Employee Assist.

Supplemental Coverage (Disability, CI,

Career Growth and Development Opportun

Job summary

SGA Dental Partners is seeking a Credentialing Specialist to manage end-to-end credentialing and recredentialing for dental providers. The role emphasizes accurate records, HIPAA compliance, and regulatory alignment across credentialing databases and networks.

Responsibilities include tracking license expirations, maintaining provider data, and coordinating communications with offices and management to ensure timely processing of credentialing requirements.

Qualifications

• Associate Degree preferred.
• 1–3 years credentialing experience ideal.
• Strong understanding of insurance payor processes and credentialing standards.

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.
• Provide administrative support for credentialing, network participation, and specialty service operations.
• Resolve inquiries and insurance plan discrepancies related to credentialing and provider status.
• Maintain confidentiality of provider and patient information per HIPAA.

Skills

MS Excel

MS Word

Practice Management software

Attention to detail

HIPAA compliance

Communication skills

Education

Associate degree preferred

1-3 years credentialing experience

Tools

Practice Management software

MS Excel

Job description

SGA Dental Partners is seeking a Credentialing Specialist to manage end-to-end credentialing and recredentialing for dental providers. The role emphasizes accurate records, HIPAA compliance, and regulatory alignment across credentialing databases and networks.

Responsibilities include tracking license expirations, maintaining provider data, and coordinating communications with offices and management to ensure timely processing of credentialing requirements.