Remote Credentialing Specialist – Dental Providers

SGA Dental Partners; Claxton (GA); Remote; USD 40,000 - 60,000; Full time

Benefits offered by this job

Paid Holidays

401(k) Retirement Plan

Health and Vision Insurance

Employer-Paid Dental Insurance

Life Insurance

Care.com Membership

Employee Assistance Program

Supplemental Coverage

Job summary

SGA Dental Partners is seeking a Credentialing Specialist to manage end-to-end credentialing and recredentialing for dental providers, ensuring accuracy and HIPAA-compliant data across databases. You will track licenses, renewals, and payor requirements, coordinate with offices, and support network participation, while maintaining confidentiality and upholding regulatory standards.

This role offers remote eligibility in many states and opportunities for professional growth within a collaborative

Qualifications

• Associate degree preferred and 1–3 years of credentialing experience.
• Strong understanding of insurance payor processes and credentialing standards.
• Experience with provider data management and HIPAA compliance.

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

Professional communication

Data confidentiality

Team collaboration

Education

Associate degree

Tools

MS Word

Job description

SGA Dental Partners is seeking a Credentialing Specialist to manage end-to-end credentialing and recredentialing for dental providers, ensuring accuracy and HIPAA-compliant data across databases. You will track licenses, renewals, and payor requirements, coordinate with offices, and support network participation, while maintaining confidentiality and upholding regulatory standards.

This role offers remote eligibility in many states and opportunities for professional growth within a collaborative