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Credentialing Associate Jobs in Ohio (NOW HIRING)

gesmv

Credentialing & Billing Specialist

Dayton, OH

Summary The Credentialing & Billing Specialist is responsible for ensuring accurate and timely ... Associate degree required; bachelor's degree in healthcare administration, business or related ...

gesmv

Credentialing & Billing Specialist

Dayton, OH · On-site

Summary The Credentialing & Billing Specialist is responsible for ensuring accurate and timely ... Associate degree required; bachelor's degree in healthcare administration, business or related ...

Monzingo | Legal

Associate Attorney

Tipp City, OH · On-site

Competitive compensation relative to experience level and credentials * Bonuses eligible * Health ... This associate attorney position is an outstanding opportunity for new attorneys with excellent ...

Monzingo | Legal

Associate Attorney

Tipp City, OH

Competitive compensation relative to experience level and credentials * Bonuses eligible * Health ... This associate attorney position is an outstanding opportunity for new attorneys with excellent ...

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All JobsCredentialing Associate JobsCredentialing Associate Jobs in Ohio

Credentialing Associate information

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$13

$23

$37

How much do credentialing associate jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for credentialing associate in Ohio is $23.16, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $26.30 per hour, depending on experience, location, and employer.

How much does a credentialing specialist make in the US?

A credentialing specialist in the US typically earns between $40,000 and $55,000 annually, depending on experience, location, and employer size. Salaries can increase with certifications and advanced knowledge of healthcare compliance and credentialing processes.

Is credentialing specialist a stressful job?

Credentialing specialists often work in fast-paced healthcare or insurance environments, where accuracy and meeting deadlines are critical. The job can be stressful due to the need for attention to detail, managing multiple applications, and ensuring compliance with regulations, but workload and stress levels vary depending on the organization and individual experience.

How to get in credentialing entry level?

To start as a credentialing associate at an entry-level, candidates typically need a high school diploma or equivalent, strong organizational skills, and attention to detail. Relevant experience in healthcare, insurance, or administrative roles can be beneficial, and familiarity with credentialing software or databases is often preferred.

What does a credentialing associate do?

A credentialing associate is responsible for verifying the qualifications, licenses, certifications, and credentials of healthcare providers or other professionals to ensure compliance with industry standards and regulations. They review and process application documents, maintain accurate records, and coordinate with licensing boards and insurance companies. Strong attention to detail and familiarity with credentialing software are essential for this role.

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

To thrive as a Credentialing Associate, you need strong organizational skills, attention to detail, and familiarity with credentialing processes, typically supported by a high school diploma or relevant associate degree. Proficiency in credentialing management software, databases, and knowledge of regulatory standards such as NCQA or The Joint Commission is important. Excellent communication, time management, and problem-solving abilities help you effectively interact with providers and resolve documentation issues. These skills ensure accurate and timely credentialing, compliance with regulations, and the smooth onboarding of healthcare professionals.

What are Credentialing Associates?

Credentialing Associates are professionals who manage and verify the qualifications and credentials of healthcare providers, such as doctors and nurses, to ensure they meet all necessary standards and regulations. Their responsibilities include collecting, verifying, and maintaining documentation like licenses, certifications, and work history. They play a crucial role in healthcare organizations by ensuring that only qualified providers are allowed to deliver patient care, helping maintain patient safety and regulatory compliance.

What are some common challenges Credentialing Associates face when verifying practitioner credentials, and how can they be addressed?

Credentialing Associates often encounter challenges such as missing or incomplete documentation, discrepancies in practitioner information, and delays in responses from licensing boards or references. To address these issues, it is essential to develop strong organizational skills, maintain diligent follow-ups, and utilize checklists or credentialing software to track progress. Collaborating closely with providers and other team members also helps streamline the process and resolve issues efficiently.

What is the difference between Credentialing Associate vs Credentialing Specialist?

AspectCredentialing AssociateCredentialing Specialist
Required CredentialsHigh school diploma or equivalent; some roles may prefer certificationHigh school diploma or equivalent; certification often preferred
Work EnvironmentHealthcare organizations, insurance companies, or credentialing firmsHealthcare facilities, insurance companies, or credentialing agencies
Employer & Industry UsageCommonly used in healthcare and insurance sectorsWidely used in healthcare credentialing departments
Search & Comparison IntentOften compared for entry-level roles or career progressionCompared for specialized credentialing tasks

The Credentialing Associate and Credentialing Specialist roles share similar environments and required credentials, often involving healthcare or insurance organizations. The main difference lies in scope: Credentialing Specialists typically handle more complex credentialing processes and may require more experience or certifications. Both roles are essential in ensuring providers meet licensing and credentialing standards, but the Specialist role often involves more responsibility and expertise.

What are the most commonly searched types of Credentialing jobs in Ohio? The most popular types of Credentialing jobs in Ohio are:
What cities in Ohio are hiring for Credentialing Associate jobs? Cities in Ohio with the most Credentialing Associate job openings:
Credentialing Associate jobs near you
Infographic showing various Credentialing Associate job openings in Ohio as of July 2026, with employment types broken down into 1% As Needed, 68% Full Time, 29% Part Time, 1% Temporary, and 1% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $48,167 per year, or $23.2 per hour.
Credentialing & Billing Specialist

Credentialing & Billing Specialist

Goodwill Easterseals Miami Valley

Dayton, OH • On-site

Full-time, Part-time

Posted 7 days ago

Goodwill Easter Seals Miami Valley rating

7.2

Company rating: 7.2 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

265th of 707 rated non-profit organizations

Job description

Do you have a desire to work for an organization driven by empowerment and full inclusion? Goodwill Easterseals Miami Valley is one of the largest employers in the region; with the mission to empower those with disadvantages and disabilities to improve their quality of life. We employ over 600 associates just in our retail stores alone. GESMV also offers over 40 programs and services to the community ranging from job readiness programs to assistive technology services. We offer part-time and full-time positions, with a variety of schedules and hours available. We are always looking for driven, enthusiastic people to join our team.
Summary
The Credentialing & Billing Specialist is responsible for ensuring accurate and timely provider credentialing, payer enrollment, and revenue cycle support. This role serves as a critical bridge between front-end operations and billing, helping prevent denials, improve compliance, and optimize reimbursement outcomes.
Essential Duties & Responsibilities
Credentialing & Payer Enrollment
  • Advise on end-to-end provider credentialing and payer enrollment processes, including initial applications, re-credentialing and ongoing maintenance
  • Maintain and update provider information in PNM System, CAQH, PECOS and payer-specific portals
  • Track credentialing and enrollment status, ensuring timely completion and preventing lapses in participation
  • Serve as the primary point of contact with payers for enrollment status, issue resolution, and follow-up
  • Maintain accurate records of provider credentials, licenses, certifications, and payer participation status.

Process Design & Optimization
  • Design, implement and continuously improve credentialing and enrollment workflows to increase efficiency and reduce delays
  • Establish tracking systems and controls for re-credentialing cycles, expirations, and compliance requirements
  • Identify root causes of enrollment or credentialing delays and implement process improvements
  • Collaborate with leadership to standardize and document processes across revenue cycle functions

Front-End Revenue Cycle Support
  • Advise and support front desk and intake staff on best practices for eligibility verification, insurance capture, and authorization processes
  • Assist in developing and improving front-end workflows to ensure accurate patient and payer information before services are rendered
  • Identify trends in eligibility or intake errors that contribute to claim denials and recommend corrective actions
  • Support training and guidance for staff related to front-end revenue cycle processes

Billing & Denial Support
  • Assist with medical billing functions including claim submission, follow-up, and resolution of denials
  • Analyze denial patterns and partner with front-end and credentialling functions to address root causes
  • Work collaboratively with billing staff to ensure clean claim submission and timely reimbursement
  • Support continuous improvement in clean claims rates, A/R performance, and denial reduction

Compliance & Data Integrity
  • Ensure compliance with HIPAA, CARF, payer requirements, and regulatory guidelines related to credentialing and billing
  • Maintain confidentiality and security of protected health information (PHI)
  • Support audit preparation and documentation of credentialing, enrollment, and revenue cycle processes
  • Promote data accuracy and consistency across systems used for credentialing, billing, and provider management

Other duties as assigned
Supervisory Responsibilities
None
Education Requirements
Associate degree required; bachelor's degree in healthcare administration, business or related field preferred. At least 5 years of related experience may be considered in lieu of degree.
Experience Requirements
  • Minimum of 3-5 years of experience in medical billing, credentialing, payer enrollment, or revenue cycle operations.
  • Demonstrated hands-on experience with provider credentialing and payer enrollment processes.
  • Experience working with Medicare, Medicaid, and commercial payers.
  • Familiarity with eligibility verification and front-end revenue cycle workflows.
  • Experience identifying and resolving claim denials or reimbursement issues.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
  • Ability to pass a criminal background check.
  • Must maintain a valid driver's license in preparation for any driving for the agency.

Skills & Abilities
  • Strong knowledge of credentialing, payer enrollment, and revenue-cycle processes
  • Understanding of how front-end processes impact billing outcomes and denial rates
  • Experience with credentialing systems (e.g. PECOS) and billing/EMR platforms
  • Excellent organizational skills with the ability to track multiple providers, deadlines, and requirements
  • Strong analytical and problem-solving skills with a focus on root cause analysis
  • Ability to design and improve workflow processes
  • High attention to detail and commitment to data accuracy
  • Effective communication skills with the ability to work cross-functionally (billing, intake, clinical, and leadership teams)
  • Strong understanding of HIPAA and payer compliance requirements

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
  • The ability to regularly sit and talk or hear.
  • The ability to identify the details in numbers.
  • The ability to perform computer work and data entry.
  • The ability to regularly stand, walk, use of hands to finger, handle, or operate objects, tools, or controls
  • The occasional ability to climb, balance, stoop, kneel, crouch, or crawl, and smell.
  • The ability to regularly lift and/or move up to 10 pounds.
  • The ability to occasionally lift and/or move up to 25 pounds.
  • The ability of close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
  • The noise level in the work environment is usually low to moderate.

The above duties and responsibilities are essential job functions subject to reasonable accommodation. The employee must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job and/or apply for the position, absent undue hardship.This job description is not to be interpreted as an all-inclusive list of duties, responsibilities, or requirements. Employees may be required to perform additional job- related tasks as assigned, subject to reasonable accommodation.
Goodwill Easterseals Miami Valley is firmly committed to Equal Employment Opportunity (EEO) and Affirmative Action (AA) compliance with all Federal, State, and local laws that prohibit employment discrimination on the basis of age, sex, color, race, creed, national origin, religion, marital status, citizenship status, ancestry, sexual orientation, gender identity and/or expression, genetic information, disability status, protected veteran status, membership or activity in a local human rights commission, status with regard to public assistance, or any other classification protected by applicable law. This policy applies to all employment decisions, including, but not limited to recruiting, hiring, training, promotions, pay practices, benefits, disciplinary actions, and terminations.

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