Dental Network Account Executive — Hybrid Credentialing

Enlightened, Inc.; Washington (District of Columbia); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

401(k) plan

Paid holidays

Paid vacation

Training reimbursement

HSA

FSA

Medical/Dental/Vision insurance

Job summary

Enlightened, Inc. in Washington, DC is seeking a Dental Provider Network Account Executive to develop and maintain strong relationships with participating dental providers and support credentialing, enrollment, and contract administration.

You will coordinate provider data management across multiple systems, ensure regulatory compliance, and collaborate with internal teams and external vendors to maintain network integrity and timely claims processing.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Public Health, or related field, or an equivalent combination of education and experience.
• Three (3) or more years of experience in provider network management, provider relations, credentialing, provider enrollment, contracting, or healthcare operations.
• Experience supporting provider credentialing and enrollment activities.
• Working knowledge of managed care, Medicaid, Medicare, or commercial health plans.
• Strong organizational and time management skills with the ability to manage multiple priorities.
• Excellent verbal and written communication skills.
• Strong customer service and relationship management skills.
• Proficiency with Microsoft Office, including Excel, Word, and Outlook.

Responsibilities

• Manage the end-to-end provider credentialing and recredentialing process.
• Coordinate new provider enrollment from application through approval.
• Partner with delegated credentialing teams to ensure provider files are complete and regulatory requirements are met.
• Follow up with providers to obtain missing documentation and resolve credentialing deficiencies.
• Prepare provider contracts and coordinate execution with internal leadership.
• Maintain accurate provider records within LIFT and other provider management systems.
• Coordinate provider site visits required for credentialing and recredentialing.
• Support provider contracting activities, including new provider onboarding and ongoing provider maintenance.
• Manage provider additions, terminations, demographic updates, practice location changes, and provider profile maintenance.
• Maintain accurate provider information within Skygen to support claims processing and network operations.
• Coordinate provider site visits with American Dental Systems.
• Investigate and resolve provider claims and reimbursement issues.
• Serve as the primary operational contact for participating dental providers.
• Build and maintain strong relationships with Federally Qualified Health Centers (FQHCs), private dental practices, and group dental practices.
• Monitor Medicaid Identification Numbers (MAIDs) for participating providers and provider groups.
• Ensure provider records remain compliant with organizational, contractual, and regulatory requirements.
• Identify opportunities to improve operational processes and workflow efficiencies.
• Collaborate with internal departments to support provider network initiatives.
• Participate in weekly, biweekly, and monthly operational meetings, as well as cross-functional projects.

Skills

Organizational skills

Communication skills

Customer service

Relationship management

Time management

Attention to detail

Education

Bachelor's degree in Healthcare Administration or related field

Tools

Excel

Word

Outlook

Skygen

LIFT

Job description

Enlightened, Inc. in Washington, DC is seeking a Dental Provider Network Account Executive to develop and maintain strong relationships with participating dental providers and support credentialing, enrollment, and contract administration.

You will coordinate provider data management across multiple systems, ensure regulatory compliance, and collaborate with internal teams and external vendors to maintain network integrity and timely claims processing.