Credentialing Specialist

SGA Dental Partners is hiring a Credentialing Specialist. This role is responsible for managing the end-to-end credentialing and recredentialing process for dental providers, ensuring accurate records, compliance with dental plan and regulatory requirements, timely application processing, and ongoing maintenance of provider data and documentation systems.

• →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

• Knowledge of English composition, grammar, spelling and punctuation.
• Skilled in the use of basic office equipment such as: telephones, calculators, copier, fax, computers and computer software (MS Excel, Word, Practice Management software).
• Proficient in Microsoft Excel
• Ability to be professional and maintain composure when dealing with stressful situations.
• Ability to cooperatively work with the doctors, co-workers, various facilities, and patients and build relationships of trust.
• Maintain confidence with the patient regarding doctors and staff.
• Ability to prioritize, organize and complete tasks timely.
• Ability to accept constructive criticism.
• Ability to understand and follow written and verbal instructions.
• Ability to collect data, establish facts and maintain confidentiality.
• Ability to communicate and express thoughts and ideas clearly and competently.
• Ability to quickly grasp relevant concepts regarding duties and responsibilities.
• Treat patients, co-workers, and doctors professionally and courteously.

• Associate Degree preferred
• 1-3 years of medical/dental credentialing experience ideal
• Strong understanding of insurance payor processes, credentialing standards, and provider data management preferred.