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Credentialing Compliance Analyst Jobs (NOW HIRING)

Slope

Senior Compliance Analyst

Washington, DC · On-site

$146 - $194/hr

CISSP, CISA, CRISC, CISM, or equivalent compliance/security credentials. * Advanced Degree: Master's degree in Business Administration (MBA), Cybersecurity, or a related discipline. * GRC Tooling:

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Bayhealth

Facilities Compliance Analyst

Dover, DE · On-site

Provides reports as needed by departmental leadership to ensure compliance with WO and PM goals and ... Credential(s): * Driver License Driving Record Required. Due to insurance carrier requirements all ...

Network Temp Inc

Credentialing Coordinator

Bronx, NY

$30 - $35/hr

... analysis of provider applications, accompanying documents and files for new and existing providers. * Identify discrepancies and resolve them quickly, ensuring credentialing compliance, including but ...

Network Temp Inc

Credentialing Coordinator

New York, NY · On-site

$30 - $35/hr

... analysis of provider applications, accompanying documents and files for new and existing providers. * Identify discrepancies and resolve them quickly, ensuring credentialing compliance, including but ...

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How much do credentialing compliance analyst jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for credentialing compliance 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 a credentialing compliance analyst?

Credentialing Compliance Analysts are professionals who ensure that healthcare providers and organizations adhere to industry regulations and standards regarding credentials. They review, verify, and monitor the qualifications, licenses, and certifications of healthcare staff to ensure compliance with legal and accreditation requirements. These analysts play a crucial role in minimizing risks, maintaining quality standards, and supporting the integrity of healthcare services. Their responsibilities often include conducting audits, managing documentation, and staying updated on regulatory changes.

What are the key skills and qualifications needed to thrive as a credentialing compliance analyst?

To thrive as a Credentialing Compliance Analyst, you need a solid understanding of credentialing processes, regulatory standards, and healthcare compliance, often supported by a bachelor’s degree in healthcare administration or a related field. Familiarity with credentialing management software, databases, and knowledge of standards such as NCQA or JCAHO is typically required. Strong attention to detail, analytical thinking, and effective communication skills help ensure accuracy and collaboration across teams. These competencies are vital for maintaining organizational compliance, reducing risk, and ensuring qualified healthcare provider participation.

What are the most common challenges faced by credentialing compliance analysts during the provider onboarding process?

Credentialing Compliance Analysts often encounter challenges such as incomplete or inconsistent documentation from providers, tight deadlines to meet regulatory requirements, and frequent updates to compliance standards. Navigating these issues requires strong attention to detail, clear communication with providers and internal teams, and the ability to stay organized under pressure. Collaboration with medical staff, human resources, and legal departments is essential to ensure accurate and timely credentialing, which directly impacts provider readiness and organizational compliance.

What is the difference between Credentialing Compliance Analyst vs Credentialing Specialist?

AspectCredentialing Compliance AnalystCredentialing Specialist
Required CredentialsTypically requires a certification in compliance or healthcare administrationOften requires certification in medical billing or credentialing
Work EnvironmentHealthcare organizations, insurance companies, or credentialing firmsHospitals, clinics, or healthcare provider offices
Employer & Industry UsageUsed across healthcare compliance and credentialing departmentsCommonly employed in provider credentialing and onboarding
Search & Comparison IntentOften compared for compliance roles involving regulationsCompared for operational credentialing tasks

The Credentialing Compliance Analyst focuses on ensuring credentialing processes meet regulatory standards and compliance requirements, often involving audits and policy adherence. In contrast, the Credentialing Specialist handles the day-to-day credentialing of healthcare providers, verifying licenses and certifications. Both roles are essential in healthcare credentialing but differ mainly in their focus on compliance versus operational credentialing tasks.

What cities are hiring for Credentialing Compliance Analyst jobs?

Cities with the most Credentialing Compliance Analyst job openings:

What states have the most Credentialing Compliance Analyst jobs?

States with the most job openings for Credentialing Compliance Analyst jobs include:

Credentialing Compliance Analyst jobs near you
Infographic showing various Credentialing Compliance Analyst job openings in the United States as of July 2026, with employment types broken down into 89% Full Time, 6% Part Time, 1% Temporary, and 4% Contract. Highlights an 83% Physical, 7% Hybrid, and 10% Remote job distribution, with an average salary of $52,870 per year, or $25.4 per hour.

Clinical Credentialing and Compliance Specialist

High Point University

High Point, NC • On-site

Full-time

Re-posted 15 days ago

High Point University rating

7.0

Company rating: 7.0 out of 10

Based on 12 frontline employees who took The Breakroom Quiz

436th of 619 rated colleges and universities

Job description

High Point University is seeking a Clinical Credentialing and Compliance Specialist who is responsible for managing the credentialing, recredentialing, and ongoing compliance activities for licensed clinical providers primarily within dental services and emerging optometry clinical operations, including medical billing and payer requirements associated with dental procedures billed under medical insurance. This role ensures that all providers meet federal, state, accreditation, payer, and organizational requirements prior to appointment and throughout the duration of their service. The Specialist serves as a key liaison between providers, licensing boards, payers, and internal departments to maintain accurate, timely, and compliant credentialing records.
QUALIFICATIONS
Education
  • Associate's degree required; bachelor's degree in healthcare administration, business management, or a related field preferred.
  • Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred.
  • Experience in an academic dental or optometry clinic setting, FQHC, or multi-specialty practice preferred.
  • Familiarity with Joint Commission, NCQA, HRSA, CMS, and state-specific regulatory requirements.

Experience and Training
  • Minimum of 2 years of healthcare credentialing experience with emphasis on dental providers and services, including medical and optometry credentialing as applicable.
  • CAQH enrollment and maintenance knowledge.
  • Medicare enrollment and revalidation knowledge required.
  • Knowledge of NCQA, Joint Commission, CMS, and state licensing requirements.

Knowledge, Skills, Ability
  • In-depth knowledge of dental and optometry regulatory requirements, licensure standards, and compliance obligations.
  • Strong analytical and problem-solving skills.
  • Excellent communication and interpersonal skills.
  • Detail-oriented and highly organized.
  • Proficiency in credentialing software and compliance tools.
  • Professional certifications in healthcare credentialing, compliance, or dental practice management are a plus.

ESSENTIAL FUNCTIONS
Credentialing and Enrollment Management
  • Coordinate initial credentialing and recredentialing for dental, and optometry providers, including dentists, optometrists, and other licensed clinical personnel, including medical payer enrollment related to dental services as applicable.
  • Verify education, training, licensure, board certification, DEA registration, clinical privileges, work history, and professional references in accordance with organizational policy and regulatory standards.
  • Prepare and maintain credentialing files, ensuring all documentation is complete, accurate, and current.
  • Track expirations and proactively manage renewals for licenses, certifications, malpractice insurance, and other required credentials.
  • Prepare credentialing files for review by credentialing committees, clinical leadership, or governing bodies.
  • Develop and implement efficient enrollment procedures for new dental and optometry providers, optimizing the onboarding process and minimizing time-to-productivity.

Compliance and Regulatory Oversight
  • Ensure credentialing processes comply with applicable regulations and standards, including but not limited to CMS, Joint Commission, NCQA, HRSA, state licensing boards, and payer requirements.
  • Monitor and ensure compliance with dental and optometry regulatory requirements, including state and federal laws and payer standards.
  • Assist with audits, site visits, and surveys by accrediting bodies and regulatory agencies; compile and present requested documentation.
  • Identify compliance gaps or credentialing risks and escalate concerns to leadership as appropriate.

Data Management and Reporting
  • Maintain credentialing data within credentialing management systems, HRIS, or other databases.
  • Generate reports related to credentialing status, expirations, compliance metrics, and audit readiness.
  • Ensure confidentiality and security of all credentialing and provider information.

Collaboration and Communication
  • Serve as primary point of contact for providers regarding credentialing, recredentialing, and compliance questions.
  • Coordinate with Human Resources, Billing, and Clinical Leadership to support provider onboarding and ongoing compliance.
  • Provide guidance and education to providers related to credentialing and timelines.

ACCOUNTABILITY
Reports to the Manager of Clinical Revenue Operations Cycle. Performance is evaluated based on credentialing accuracy, compliance outcomes, onboarding timeliness, and audit readiness.
For more information regarding this position, please contact Jennifer Hicks, Manager of Clinical Revenue Operations Cycle at jhicks4@highpoint.edu.

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