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Credentialing Analyst information

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$14

$24

$40

How much do credentialing analyst jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for credentialing analyst in Ohio is $24.16, according to ZipRecruiter salary data. Most workers in this role earn between $17.84 and $26.06 per hour, depending on experience, location, and employer.

What is 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?

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 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.

What does a credentialing analyst do?

A credentialing analyst reviews and verifies the credentials, licenses, and certifications of healthcare providers or other professionals to ensure compliance with industry standards and regulations. They manage documentation, update databases, and coordinate with licensing boards, often using credentialing software, to facilitate provider onboarding and maintain accurate records.
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Credentialing Analyst jobs near you
Infographic showing various Credentialing Analyst job openings in Ohio as of August 2026, with employment types broken down into 86% Full Time, 7% Part Time, 1% Temporary, and 6% Contract. Highlights an 81% Physical, 8% Hybrid, and 11% Remote job distribution, with an average salary of $50,263 per year, or $24.2 per hour.

Billing Manager and Credentialing

Community Corrections Association, Inc.

Youngstown, OH • On-site

Full-time

Re-posted 16 days ago

Job description

Billing ManagerPosition Overview

The Billing & Credentialing Manager is responsible for overseeing all billing operations and credentialing processes to ensure accurate, timely claim submission and full compliance with healthcare regulations. This role manages billing staff, monitors workflows, resolves claim issues, and collaborates with internal departments to optimize reimbursement and revenue cycle performance. ONSITE, YOUNGSTOWN OHIO. 

Key ResponsibilitiesBilling Operations
  • Oversee all billing functions, including claim generation, submission, and follow-up.
  • Ensure accurate and timely claim batch creation for Medicaid, MCOs, and SmartCare.
  • Monitor deposits, including Medicaid/MCO payments and SmartCare transactions.
  • Research payment discrepancies; adjust client balances as needed.
  • Resolve zero-dollar payments from Medicaid and MCOs.
  • Investigate and correct failed or denied claims, including contacting payers.
  • Maintain and update billing batch logs weekly.
  • Process and reconcile past deposits.
  • Complete billing for ACT team services.
  • Ensure consistent weekly claim creation to maintain steady cash flow.
  • Maintain a strong working knowledge of the Billing Matrix within Credible.
  • Analyze reimbursement trends and implement process improvements to maximize revenue.
  • Ensure compliance with all internal policies and external billing regulations.
Credentialing & Compliance
  • Oversee credentialing for all providers across COMPASS locations.
  • Complete credentialing for new hires within 14 days of employment.
  • Prepare and process credentialing documents for licensed professionals.
  • Obtain NPIs for licensed staff and Medicaid numbers for non-licensed staff.
  • Conduct monthly Medicare provider eligibility verifications.
  • Maintain and update the master list of insurance contracts and electronic records.
  • Obtain required signatures on insurance contracts and amendments.
  • Maintain and update the insurance grid to ensure accurate provider eligibility by payer.
  • Prepare licensed staff for Behavioral Health redesign, including applications and W9 forms.
  • Collaborate with HR to initiate credentialing for new employees.
Reporting & Coordination
  • Update ACT spreadsheet monthly with payment activity.
  • Serve as liaison between billing and clinical departments.
  • Manage and supervise billing staff to ensure productivity and accuracy.
  • Identify and implement workflow improvements across billing and credentialing functions.
  • Perform additional duties as assigned by leadership.
Qualifications
  • Experience: Minimum of 3 years in medical billing (required)
  • Knowledge:
    • Medicaid and commercial insurance billing (required)
    • Behavioral health billing (preferred)
    • CPT coding and claim accuracy
    • Electronic healthcare billing systems (e.g., Credible)
  • Skills:
    • Strong attention to detail and organizational abilities
    • Advanced proficiency in Microsoft Excel and Office Suite
    • Excellent communication and problem-solving skills
    • Ability to manage multiple priorities and meet deadlines
Physical Requirements
  • Prolonged periods of sitting and occasional standing/walking
  • Frequent use of hands for computer work and office equipment
  • Ability to lift up to 25 pounds
  • Occasional bending, kneeling, crouching, or reaching
Key Competencies
  • Leadership and team management
  • Analytical thinking and process improvement
  • Regulatory compliance awareness
  • Revenue cycle optimization
  • Cross-functional collaboration


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