Credentialing Manager

Role Overview

• Lead and manage provider credentialing and payer enrollment for a growing Dental Support Organization (DSO)
• Ensure accurate, efficient, and timely credentialing to support revenue continuity across multiple practices and payers
• Manage dental insurance credentialing and DSO-scale operations
• Proactively handle payer relationships, timelines, and compliance requirements
• Oversee end-to-end provider credentialing and re-credentialing for dentists within Medicaid and commercial networks
• Manage payer enrollments, TIN updates, and provider records ensuring accuracy, compliance, and timely reimbursement
• Support fee schedule negotiations, ensuring correct fee schedules are maintained with all contracted payers
• Maintain accurate credentialing records, CAQH profiles, and payer portals
• Act as the primary liaison between practices, payers, and internal RCM teams for credentialing functions
• Track credentialing status, deadlines, and expirations; proactively resolve issues
• Develop and maintain credentialing workflows, standard operating procedures (SOPs), and tracking tools
• Identify opportunities to improve turnaround times, reduce denials, and enhance payer communication

Requirements

• Minimum 3 years of dental credentialing experience, preferably within a DSO or multi-location group
• Proven experience credentialing with major dental PPOs, Medicaid plans, and TPAs
• Strong understanding of dental payer requirements, timelines, and enrollment processes
• Experience managing credentialing for multiple providers and locations simultaneously
• High attention to detail with excellent organizational and follow-up skills
• Proficiency with credentialing databases, payer portals, and Excel-based tracking
• Ability to work independently in a fast-paced, high-volume environment