Credentialing Manager

Position: Credentialing Manager Location: Remote Department: Revenue Cycle Reports To: Director of RCM Position 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 Key Responsibilities: • 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 Required Qualifications: • 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 Preferred Qualifications: • Familiarity with dental revenue cycle management (RCM) workflows and downstream revenue impacts • Prior experience in people management or vendor oversight • Knowledge of Denticon, Open Dental, Eaglesoft, or similar dental practice management systems (PMS)