Credentialing Specialist

Credentialing Specialist (Dental / Healthcare)

Location: Remote Type: Full-Time Schedule: Must have overlap with U.S. business hours Compensation: Depending on experience and location

About the Company

We are a growing healthcare services organization focused on supporting provider enrollment, payer credentialing, and operational excellence across the healthcare and dental industries. We are seeking a highly detail-oriented Credentialing Specialist to support provider onboarding, payer enrollment, and ongoing credential maintenance processes.

This is an excellent opportunity for someone who thrives in process-driven environments, understands U.S. healthcare or dental credentialing workflows, and can independently manage applications, follow-ups, and documentation with accuracy and urgency.

The Opportunity

We are looking for a Credentialing Specialist with at least 2 years of experience in dental or healthcare credentialing. This role will be responsible for managing payer applications, maintaining provider data, handling CAQH updates, and supporting ongoing enrollment and recredentialing processes.

The ideal candidate is organized, proactive, highly detail-oriented, and comfortable navigating multiple payer portals and systems simultaneously.

Key Responsibilities

Provider Credentialing & Enrollment

• Complete and submit payer credentialing and enrollment applications accurately and on time
• Manage initial credentialing, recredentialing, and provider updates
• Maintain provider records and supporting documentation
• Track application statuses and proactively follow up with insurance payers
• Ensure provider information remains current across all systems and portals

CAQH & CredentialStream Management

• Maintain and update CAQH provider profiles
• Work within CredentialStream and other credentialing platforms
• Upload and organize required credentialing documentation
• Monitor expiration dates for licenses, malpractice insurance, certifications, and related documents

Payer Communication & Follow-Up

• Communicate with insurance payers regarding application status, missing information, and approvals
• Resolve credentialing issues or discrepancies efficiently
• Maintain organized logs and reporting related to credentialing activity

Administrative & Operational Support

• Maintain accurate spreadsheets and credentialing trackers using Excel
• Assist with audits and compliance documentation as needed
• Support internal operational workflows and process improvements

Requirements

• Minimum 2 years of credentialing experience in healthcare or dental environments
• Strong experience with: CAQH, CredentialStream, Excel / Google Sheets, completing payer applications
• Familiarity with U.S. healthcare insurance and credentialing processes
• Excellent organizational and documentation skills
• Strong written and verbal English communication
• Ability to manage multiple deadlines and follow-up tasks simultaneously
• High attention to detail and accuracy

Preferred Qualifications

• Experience credentialing dental providers
• Familiarity with Medicare, Medicaid, and commercial payer enrollment
• Experience working remotely with U.S.-based teams
• Knowledge of provider compliance documentation and audits

Ideal Candidate Traits

• Process-oriented and highly organized
• Persistent with payer follow-ups
• Comfortable working independently
• Strong sense of ownership and accountability
• Able to prioritize effectively in a fast-paced environment

What Success Looks Like

• Credentialing applications are submitted accurately and on time
• Provider records remain organized and fully up to date
• Payer follow-ups are handled proactively
• Recredentialing deadlines are never missed
• Internal teams can rely on clean, accurate credentialing data