Credentialing Specialist

About the role

We are looking for a Credentialing Specialist to support provider enrollment and payer relations for dental practices in Great Neck, New York. This Long-term Contract position focuses on keeping dental providers properly credentialed, enrolled, and in good standing with commercial plans and government payers. The person in this role will work closely with insurance representatives and internal teams to help maintain accurate records, prevent participation gaps, and address issues that affect reimbursement.

Responsibilities

• Manage credentialing and recredentialing activities for dentists, specialists, and hygienists with commercial insurers, Medicaid, and other payer organizations.
• Complete and submit enrollment applications with all required documentation, then monitor progress through approval.
• Maintain provider records such as licenses, liability coverage, and other credentialing documents needed for network participation.
• Communicate with insurance carriers and payer contacts to obtain updates, resolve pending items, and support timely enrollment decisions.
• Review notices from payers, including contract updates, participation changes, and revalidation requests, and take appropriate follow-up action.
• Partner with billing, front office, and practice leadership teams to investigate claim denials and reimbursement concerns tied to credentialing status.
• Track expiration dates, renewal timelines, and payer-specific deadlines to reduce the risk of lapses in active participation.
• Keep credentialing files, status logs, and reporting data organized, current, and audit-ready.
• Assist with compliance reviews and documentation audits related to provider enrollment and payer participation.

Requirements

• At least 2 years of experience in provider credentialing, payer enrollment, or insurance relations within a healthcare or dental environment.
• Working knowledge of dental insurance processes, provider enrollment workflows, and credentialing standards.
• Experience interacting with commercial payers and familiarity with government-sponsored plans such as Medicaid is preferred.
• Understanding of provider data management, licensing records, and ongoing maintenance of credentialing documentation.
• Strong organizational skills with careful attention to detail and the ability to manage multiple deadlines.
• Clear written and verbal communication skills for effective interaction with payer representatives and internal stakeholders.
• Proficiency with Microsoft Office and credentialing, enrollment, or practice management systems.

Benefits

Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.