Location: Work From Home (Remote)
Shift: US Shift
Employment Type: Full-Time
Only apply if you have prior experience in US Dental Credentialing and excellent English communication skills, call / Whatsapp @ 8448838618
Job Summary
We are seeking an experienced Dental Credentialing Specialist to join our team. The ideal candidate will have hands-on experience in US dental provider credentialing and be responsible for managing the end-to-end credentialing and recredentialing process for dentists and dental specialists. The candidate should have a thorough understanding of insurance payer enrollment, provider data management, and credentialing compliance while ensuring timely approvals and accurate provider records.
Key Responsibilities
- Manage the complete credentialing and recredentialing process for dentists and dental specialists with commercial insurance payers, Medicaid, and other networks.
- Prepare, submit, and track credentialing, recredentialing, and provider enrollment applications.
- Coordinate with insurance companies to ensure timely processing of credentialing applications.
- Maintain accurate provider information in CAQH, NPI, PECOS (if applicable), and payer portals.
- Monitor application status and proactively follow up with insurance companies to resolve delays or missing documentation.
- Maintain provider licenses, DEA registrations, malpractice insurance, board certifications, and other required credentials.
- Ensure all provider records remain current and compliant with payer and regulatory requirements.
- Maintain accurate credentialing documentation and provider files.
- Coordinate with internal teams regarding provider onboarding, payer participation, and credentialing timelines.
- Resolve credentialing-related issues by communicating with insurance representatives and internal stakeholders.
- Maintain confidentiality of provider information while ensuring compliance with HIPAA and company policies.
Required Qualifications
- Bachelor's degree preferred.
- Minimum 2–4 years of hands-on experience in US Dental Credentialing.
- Strong knowledge of dental insurance credentialing and provider enrollment processes.
- Experience working with commercial dental insurance payers and government plans.
- Hands-on experience with CAQH, NPI Registry, insurance portals, and credentialing databases.
- Excellent verbal and written English communication skills.
- Strong organizational skills with exceptional attention to detail.
- Ability to manage multiple providers and meet deadlines.
- Comfortable working independently in a remote environment.
- Willingness to work during US business hours.
Preferred Qualifications
- Experience with dental practice management software such as Dentrix, Open Dental, Eaglesoft, CareStack, or SoftDent.
- Knowledge of fee schedule management.
- Experience managing insurance payer portals.
- Understanding of provider contracting and credentialing compliance requirements.
Key Skills
- Dental Credentialing
- Provider Enrollment
- Recredentialing
- CAQH Management
- Insurance Payer Portals
- NPI & Provider Data Management
- Documentation & Compliance
- HIPAA Compliance
- Time Management
- Attention to Detail
- Communication Skills
- Microsoft Office & Google Workspace
Key Performance Indicators (KPIs)
- Timely completion of credentialing and recredentialing applications.
- Provider enrollment turnaround time.
- Accuracy of provider records and documentation.
- Credentialing approval rate.
- Timely renewal of provider credentials and licenses.
- Compliance with payer and regulatory requirements.
What We Offer
- 100% Work From Home
- Competitive Salary
- Performance-Based Incentives
- Growth Opportunities
- Supportive and Collaborative Team
- Training and Career Development
Pay: ₹40,000.00 - ₹55,000.00 per month
Work Location: Remote
