Dental Credentialing - DENTAL EXPERIENCE REQUIRED

CredentialingClove Dental is seeking a meticulous and proactive Credentialing Analyst to own provider credentialing and payer enrollment across a growing, multi-location dental platform. This role is critical to ensuring every provider is fully credentialed and billable before they see patients — and that the company never loses revenue to enrollment gaps, lapsed licenses, or missed re-credentialing deadlines. Dental experience required and preferred large group experience in dental.The ideal candidate has hands-on dental credentialing experience, is relentless about deadlines and follow-up with payers, and can build clean, audit-ready systems that scale as the company opens new offices.What success looks like at 90 days:100% of provider licenses, DEA registrations, and malpractice coverage current — zero lapsesNew providers enrolled with all priority payers before or within target days of their start dateZero revenue lost to credentialing- or enrollment-related claim denialsCAQH profiles 100% current, with re-attestations completed on scheduleNew office payer enrollments completed ahead of each location's launch dateRCM and operations teams trust your credentialing pipeline as the source of truthYou will own:Initial credentialing and re-credentialing for all providersPayer enrollment and re-enrollment across commercial PPO and Medicaid/state programsCAQH profile creation, maintenance, and re-attestationLicense, DEA, and malpractice/liability tracking and renewalsInsurance payer portal access and managementNew office and location enrollment with payersFee schedule and contracted rate tracking, and support for negotiationsCredentialing records, database hygiene, and audit readinessCoordination with HR/onboarding and RCMKey ResponsibilitiesProvider Credentialing & EnrollmentComplete initial credentialing for new providers and enroll them with all relevant payers before or shortly after their start dateManage re-credentialing well ahead of expiration to prevent any lapse in billable statusCreate and maintain CAQH profiles and complete re-attestations on scheduleTrack and renew provider licenses, DEA registrations, and malpractice coverage with zero lapsesPayer & Portal ManagementMaintain access to and actively manage insurance payer portalsSubmit, track, and follow up on enrollment applications until effective dates are confirmedCommunicate confirmed provider effective dates to RCM and scheduling so billing is never disruptedEnroll new office locations with payers ahead of launch datesFee Schedules & Contracted RatesTrack contracted rates and fee schedules by payer and by locationSupport fee negotiations and maintain clear documentation of negotiated ratesFlag underperforming contracts and out-of-date rates for review and renegotiationRecords & Cross-Team CoordinationMaintain accurate, audit-ready credentialing files and a clean central databaseCoordinate with HR and onboarding on new-hire timelines so credentialing starts early enoughPartner with the RCM team to quickly resolve credentialing-related claim denialsProvide regular status reporting on the credentialing pipeline and upcoming renewalsQualificationsExperience in dental requiredExperience credentialing across multi-location dental groups (10–100+ offices) strongly preferredHands-on experience with provider enrollment and payer credentialingFamiliarity with CAQH, payer portals, and commercial and Medicaid enrollment processesWorking knowledge of dental insurance, fee schedules, and contracted ratesOpen Dental familiarity preferredStrong organizational, tracking, and documentation skillsKey CompetenciesMeticulous attention to detail and deadline trackingPersistent, professional follow-through with payersProcess-oriented mindset with a focus on building systems that scaleClear communication with providers, HR, and the RCM teamAbility to manage many concurrent applications across multiple locationsComfort with portals, spreadsheets, and adopting new tools and AIWhy Clove DentalHigh-growth, multi-location dental platformDirect impact on provider billability, revenue capture, and how fast new offices can openOpportunity to build scalable credentialing systems as the company expandsCollaborative, performance-driven culture