Dental Billing and Credentialing Specialist

Muslim Community & Health Center • Milwaukee, WI

123d

About The Position

The Dental Billing and Credentialing Specialist plays a critical role in supporting the dental department’s financial operations and provider enrollment processes. This position ensures accurate and timely submission of dental claims, manages follow-ups and denials, and maintains current provider credentials in compliance with Medicaid, Medicare, and private insurance requirements.

Requirements

• High school diploma or equivalent required; associate degree or higher in healthcare administration or related field preferred.
• Minimum 2 years of experience in dental billing and credentialing, preferably in an FQHC or community health center setting.
• Strong knowledge of CDT codes, insurance billing, and credentialing processes.
• Proficiency with dental EHR/PM systems (e.g., Dentrix, Eaglesoft, Open Dental).
• Familiarity with Medicaid, Medicare, and managed care plans.
• Excellent organizational, communication, and problem-solving skills.
• Ability to handle sensitive information with discretion and maintain HIPAA compliance.

Nice To Haves

• Experience with HRSA compliance and UDS reporting requirements.
• Bilingual (e.g., Spanish, Arabic, Hmong) a plus.
• Certified Dental Coder (CDC) or similar credential preferred.

Responsibilities

• Prepare, review, and submit dental claims to insurance carriers via electronic and/or paper submission.
• Post insurance payments and patient payments into the system accurately and reconcile accounts.
• Monitor outstanding claims and perform timely follow-ups to resolve denials, rejections, and underpayments.
• Verify patient insurance eligibility and benefits prior to services.
• Generate monthly billing reports and assist with audits or financial reconciliations.
• Communicate with dental providers and front desk staff to ensure documentation and billing accuracy.
• Coordinate initial credentialing and re-credentialing of dental providers with payers (Medicaid, Medicare, commercial insurers).
• Maintain up-to-date records of CAQH profiles, NPI registrations, and licensing information.
• Track and manage credentialing deadlines and revalidation schedules to ensure no lapse in billing privileges.
• Submit provider enrollment applications and respond to payer correspondence as needed.
• Ensure compliance with HRSA, state, and payer-specific regulations regarding billing and credentialing.
• Maintain accurate and organized records for audits and internal/external reporting.
• Stay updated with dental billing codes (CDT), payer policies, and credentialing standards.

What This Job Offers

• Education Level: Associate degree
• Number of Employees: 11-50 employees