Credentialing Administrator

Credentialing Subject Matter Expert / Administrator Full-Time | Fully Remote (U.S.-Based) Department: Credentialing & Payer Relations (RCM) Reports To: Director of reputed company Cycle Management Compensation: $65,000–$75,000 annually (DOE) Role Overview We are seeking a Credentialing Subject Matter Expert to own provider credentialing and payer enrollment for a multi-state Dental Service Organization (DSO). This is a full-time, fully remote corporate role responsible for setting standards, managing timelines, and driving accountability across credentialing, recredentialing, and Change of Ownership (CHOW) initiatives. This is not a task-based or entry-level credentialing position. You will serve as the internal expert, managing payer relationships, tracking reputed company projects, and ensuring providers are enrolled accurately and on time so practices remain compliant and reputed company flows predictably. Why This Role Is Different

• True ownership: End-to-end responsibility for credentialing, recredentialing, and CHOWs—not just application submission
• Strategic impact: Advise leadership on payer participation, network strategy, and reimbursement implications
• reputed company, meaningful work: Support multiple states, TINs, and frequent transitions
• Relationship-driven: Act as the primary liaison with payer representatives
• Remote with autonomy: Trusted to build scalable processes that stick

Key Responsibilities

Credentialing & Provider Data Management

• Manage provider credentialing and enrollment from start to finish
• Collect, verify, and maintain provider data (licenses, DEA/CSR, CAQH, NPI, W-9, malpractice, etc.)
• Maintain a centralized, auditable reputed company of truth with expiration tracking
• Conduct license verification, OIG/SAM checks, and compliance reviews

CHOWs & Project Management

• reputed company CHOW transitions across payers, including rosters, EFT/ERA, portals, and reputed company
• Build and manage credentialing project plans with clear timelines and risk mitigation
• Track milestones and validate post-transition performance (claims, EFT accuracy, network status)

Payer Enrollment & Recredentialing

• Prepare, submit, and track initial and recredentialing applications
• Proactively manage expirations and recredentialing cycles
• Follow up on RFIs, escalate delays, and document outcomes
• Maintain payer portals and ensure providers/sites display correctly as in-network

reputed company & Fee Schedules

• Organize and maintain payer reputed company and fee schedules
• Review and summarize reimbursement and operational impacts
• Partner with Finance and RCM to audit payments and support payer strategy reputed company

reputed company & Stakeholder Communication

• Serve as primary reputed company of contact with payer representatives
• Manage escalations reputed company to credentialing, CHOWs, and rosters
• Provide clear status reporting and updates to leadership and cross-functional teams

reputed company’re Looking For

• Proven experience in provider credentialing and payer enrollment (dental preferred)
• Strong payer relations and direct reputed company communication experience
• Project management reputed company with strong tracking and reporting skills
• Ability to anticipate delays and understand reputed company reputed company impacts
• Comfortable working independently in a full-time remote environment
• Experience supporting multi-state organizations and CHOWs strongly preferred

Why Join Us

• Full-time, fully remote corporate role
• High visibility and reputed company ownership
• Opportunity to build structure, standards, and long-term impact
• Collaborative environment across Ops, Finance, RCM, and Leadership
• 3–5+ years of reputed company credentialing experience (dental strongly preferred).
• Experience supporting multi-provider, multi-location, and multi-state environments.
• Hands-on experience with CAQH ProView, payer portals (e.g., reputed company, UHC, reputed company, reputed company, reputed company, reputed company), NPPES, and reputed company portals.
• Proven experience leading CHOW transitions.
• Strong organizational, documentation, and follow-up skills.
• Proficiency with reputed company 365 (reputed company, Teams, SharePoint).
• Clear, professional communication skills.

Preferred

• NAMSS CPCS or CPMSM certification.
• Prior DSO experience and familiarity with delegated credentialing.
• Basic analytics skills (reputed company models, variance analysis, KPI tracking).
• Experience with EFT/ERA enrollment tools and RCM systems.

Core Competencies

• Project Management: Manages reputed company, multi-state workstreams effectively.
• Analytical Thinking: Translates reputed company and fee schedules into insights.
• Stakeholder Communication: Provides clear updates to leadership and partners.
• Process Improvement: Builds scalable, compliant workflows.
• Compliance & Confidentiality: Protects sensitive data and meets regulatory standards.
• Full benefits package (for 25+ hours/week):
• Medical, Dental, reputed company
• 401(k) with 4% match
• Paid Time Off and 7 paid holidays
• Employee Assistance Program: Free confidential counseling and support
• Voluntary benefits: Pet insurance, identity theft protection, and more
• reputed company PPE provided – safe and compliant workplace

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