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Credentialing Analyst Jobs (NOW HIRING)

BJC HealthCare

Lead Credentialing Analyst

Saint Louis, MO · On-site

$21.58 - $35.84/hr

Louis Children's Hospital has an opportunity for a Lead Credentialing Analyst within the medical staff office. Responsibilities will include managing initial appointments with opportunities to be ...

ThreePDS Inc.

Credentialing Specialist

Dallas, TX

Credentialing Analyst Credentialing Analyst supports the credentialing program that implements federal, state and local regulatory and NCQA accreditation requirements. Ensures that all practitioners ...

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How much do credentialing analyst jobs pay per hour?

As of May 28, 2026, the average hourly pay for credentialing analyst in the United States is $25.42, according to ZipRecruiter salary data. Most workers in this role earn between $18.75 and $27.40 per hour, depending on experience, location, and employer.

What Is the Job of a Credentialing Analyst?

As a credentialing analyst, your primary responsibilities are to monitor physicians and healthcare facilities to evaluate their compliance with industry regulations. Your duties include keeping records on insurance contracts and staff credentials. You are in charge of informing them of any changes to policies. You coordinate all information and remind medical staff when they need to update credentials and practitioners' applications. You verify and validate that all information is correct and up to date, aiming to maintain the highest standards of record keeping. You also assist auditors, prepare reports, and check eligibility for providers and insurances. You can work in a hospital, clinic, or private practice.

What are the key skills and qualifications needed to thrive as a Credentialing Analyst, and why are they important?

To thrive as a Credentialing Analyst, you need strong attention to detail, analytical skills, and knowledge of healthcare regulations, typically supported by a relevant degree or experience in healthcare administration. Familiarity with credentialing software systems, databases, and compliance platforms such as CAQH, NPPES, and state licensure portals is essential. Effective communication, organizational skills, and the ability to manage confidential information make someone stand out in this role. These skills ensure accurate verification of provider credentials, regulatory compliance, and smooth onboarding processes for healthcare organizations.

What are some common challenges faced by Credentialing Analysts during the provider onboarding process?

Credentialing Analysts often encounter challenges such as incomplete or inconsistent provider documentation, tight deadlines for credentialing verifications, and navigating varying requirements from different healthcare organizations or insurance networks. These challenges require strong attention to detail, excellent communication skills to follow up with providers, and the ability to efficiently manage multiple cases simultaneously. Building relationships with both internal teams and external contacts can help streamline the process and ensure compliance with regulatory standards.

What does a Credentialing Analyst do?

A Credentialing Analyst is responsible for verifying and maintaining the credentials of healthcare professionals, such as doctors, nurses, and allied health staff. They review applications, check qualifications, contact licensing boards, and ensure compliance with industry standards and regulations. Credentialing Analysts play a key role in helping healthcare organizations maintain high-quality standards and meet legal requirements for staff credentials. Their work ensures that only properly qualified individuals are allowed to provide patient care. This position requires strong attention to detail, organizational skills, and familiarity with healthcare regulations.

What is the difference between Credentialing Analyst vs Credentialing Coordinator?

AspectCredentialing AnalystCredentialing Coordinator
Required CredentialsTypically a bachelor's degree; certifications like Certified Provider Credentialing Specialist (CPCS) are commonSimilar educational background; often holds certifications such as CPCS or Certified Medical Staff Coordinator (CMSC)
Work EnvironmentHealthcare organizations, insurance companies, or credentialing firmsHospitals, clinics, or healthcare networks
Employer & Industry UsageUsed across healthcare and insurance sectors for credentialing rolesPrimarily in healthcare settings managing provider credentialing processes

The Credentialing Analyst and Credentialing Coordinator roles share similar educational backgrounds and certifications. While both work in healthcare environments, Credentialing Analysts often focus on analyzing credentialing data and compliance, whereas Credentialing Coordinators handle the day-to-day coordination of provider documentation and credentialing processes. Both roles are essential for ensuring healthcare providers meet licensing and credentialing standards.

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Credentialing Analyst jobs near you
Credentialing Analyst

Credentialing Analyst

Shasta Community Health Center

Redding, CA • On-site

$23 - $33.80/hr

Full-time

Posted 14 days ago

Shasta Community Health Center rating

8.6

Company rating: 8.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description

Description
Base Pay: $23.00 - $ 33.80 / hour
JOB SUMMARY
Responsible for all aspects of the credentialing, re-credentialing and privileging processes for all providers who provide patient care at Shasta Community Health Center (SCHC). Maintain regular cooperation and compliance with all regulatory, accrediting, and membership-based organizations. Responsible for ensuring providers are credentialed, appointed, and are privileged with SCHC, health plans, hospitals and patient care facilities. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.
JOB DUTIES AND RESPONSIBILITIES
• Compiles and maintains current and accurate data for all providers.
• Completes provider credentialing and re-credentialing applications of SCHC providers to address SCHC obligations with outside agencies; monitors applications and follows-up as needed.
• Tracks license, DEA and professional licensing expirations for appointed SCHC providers; tracks professional liability for specially contracted providers if not covered under SCHC's FTCA coverage and gap coverage
• Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
• Maintains knowledge of current health plan and agency requirements for credentialing providers.
• Sets up and maintains provider information in online credentialing databases and system.
• Tracks license and certification expirations for all clinical staff to ensure timely renewals.
• Ensures practice addresses are current with health plans, agencies and other entities.
• Processes applications for appointment and reappointment of privileges to SCHC.
• Maintains SCHC appointment files, and information in credentialing database.
• Audits health plan directories for current and accurate provider information.
• Assists in processing care application for providers
• Identify problems with current systems, policies and procedures to ensure compliance with BPHR and HRSA Compliance Manual, other related laws and regulations, and best practices.
o Anticipate issues with current system to avoid any non- compliance.
o Assess problems and report to management team.
o Propose potential solutions and changes.
o Establish changes to systems.
o Establish training/ communications for changes to keep management team and impacted staff.
• Create and maintain required documentation for OPPE.
• Support and enforce compliance with credentialing and privileging requirements by SCHC staff in coordination with the Human Resources, Medical Staff Office Manager, and other Senior Management officers.
• Produce and analyze monthly exclusions checks and related reports for SCHC employees, contracted providers and board members.
• Develops materials for credentialing and privileging reviews.
• Coordinates and facilitates credentialing committee reviews and actions.
• Coordinates with Senior Clinical Recruiter and Medical Staff Office to assess and address credentialing and privileging needs of new staff.
• Understands and adheres to the Ethics, Compliance and Code of Conduct policy.
Additional Responsibilities
• Maintains confidentiality of provider information.
• Provides credentialing and privileging verifications.
• Performs other duties as assigned.
KNOWLEDGE, SKILLS, AND ABILITIES
• Knowledge and understanding of the credentialing process.
• Strong communication skills.
• Ability to organize and prioritize work and manage multiple priorities.
• Excellent verbal and written communication skills including letters, memos and emails.
• Ability to read, write, understand and spell English and medical terminology correctly.
• Excellent people skills and customer service orientation.
• Excellent attention to detail.
• Ability to research and analyze data.
• Ability to work independently with minimal supervision.
• Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
• Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources.
EDUCATION & EXPERIENCE
• Associate degree or equivalent training and/or experience

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