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Credentialing Manager Jobs in Wisconsin (NOW HIRING)

Float Health Inc.

WI · On-site

$120 - $135/hr

Reporting to the Recruiting, Onboarding, & Credentialing Manager, this role sits at the intersection of recruiting, marketplace operations, and analytics. You will lead efforts to recruit, activate ...

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All JobsCredentialing JobsCredentialing Manager JobsCredentialing Manager Jobs in Wisconsin

Credentialing Manager information

See Wisconsin salary details

$43.9K

$85.8K

$132.7K

How much do credentialing manager jobs pay per year?

As of Aug 10, 2026, the average yearly pay for credentialing manager in Wisconsin is $85,826.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,600.00 and $95,400.00 per year, depending on experience, location, and employer.

What does a credentialing manager do?

A credentialing manager monitors the credential status of employees and ensuring they are recertified when necessary. As a credentialing manager, your job duties involve maintaining a database of employee certifications and renewal dates, confirming that employee credentials match the requirements of their job, and helping employees renew their credentials on time by finding test dates and locations. Credentialing managers are most commonly found in the health care industry. Qualifications to become a medical credentialing manager include a bachelor’s degree in human resources, business, or a related field, and industry experience.

What is the difference between Credentialing Manager vs Credentialing Specialist?

AspectCredentialing ManagerCredentialing Specialist
ResponsibilitiesOversees entire credentialing process, manages teams, develops policiesPerforms credentialing tasks, verifies credentials, maintains records
Required CredentialsTypically requires experience in healthcare administration, certifications like Certified Provider Credentialing Specialist (CPCS)Often requires similar certifications, entry to mid-level experience
Work EnvironmentManagement level, strategic planning, team supervisionOperational, detail-oriented, administrative tasks
Industry UsageUsed across healthcare organizations, hospitals, clinicsCommonly found in healthcare facilities, physician practices

The Credentialing Manager focuses on overseeing the entire credentialing process, managing teams, and developing policies, while the Credentialing Specialist handles day-to-day credential verification and record maintenance. Both roles require relevant certifications and healthcare industry experience, but the manager role involves more strategic oversight.

What are some common challenges a credentialing manager faces when maintaining compliance with changing regulations?

Credentialing Managers often encounter the challenge of staying updated with frequently changing industry regulations and payer requirements, which can vary by state and organization. Ensuring that all provider files are consistently accurate and compliant requires diligent monitoring, regular audits, and ongoing staff training. Additionally, coordinating with multiple departments and external agencies to gather necessary documentation while meeting tight deadlines can be demanding. Proactively implementing process improvements and leveraging credentialing software can help manage these complexities effectively.

What is a credentialing manager?

Credentialing Managers are professionals responsible for overseeing the process of verifying the qualifications, licenses, and background of healthcare providers before they are allowed to work with patients or participate in insurance networks. They ensure that all providers meet regulatory and organizational standards, and maintain up-to-date records for compliance purposes. Credentialing Managers often work in hospitals, healthcare organizations, or insurance companies, collaborating with medical staff, administrators, and external agencies to manage and streamline the credentialing process.

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

To thrive as a Credentialing Manager, you need thorough knowledge of healthcare credentialing processes, compliance standards, and experience with provider enrollment, often supported by a bachelor's degree in healthcare administration or a related field. Familiarity with credentialing software systems like CACTUS or Verity, and understanding of regulatory requirements such as NCQA or The Joint Commission, are typically expected. Attention to detail, strong organizational skills, and effective communication are standout soft skills for this position. These competencies ensure accurate and efficient management of provider credentials, minimize compliance risks, and maintain quality standards within healthcare organizations.
More about Credentialing Manager jobs
What are the most commonly searched types of Credentialing jobs in Wisconsin? The most popular types of Credentialing jobs in Wisconsin are:
What are popular job titles related to Credentialing Manager jobs in Wisconsin? For Credentialing Manager jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Credentialing Manager jobs in Wisconsin look for? The top searched job categories for Credentialing Manager jobs in Wisconsin are:
What cities in Wisconsin are hiring for Credentialing Manager jobs? Cities in Wisconsin with the most Credentialing Manager job openings:
Credentialing Manager jobs near you
Infographic showing various Credentialing Manager job openings in Wisconsin as of July 2026, with employment types broken down into 6% Locum Tenens, 83% Full Time, and 11% Part Time. Highlights an 94% In-person, and 6% Remote job distribution, with an average salary of $85,826 per year, or $41.3 per hour.

Provider Enrollment Credentialing Specialist

DentaQuest

Grafton, WI • On-site

Other

Re-posted 19 days ago

DentaQuest rating

5.2

Company rating: 5.2 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

292nd of 304 rated insurance

Job description

Primary responsibilities include taking a new provider application from receipt to inclusion on directory along with ongoing updates. This includes accurate and timely entry of provider data including provider applications and contract information, status changes, payee changes, verifying all the credentialing criteria for practitioners that have applied to the network, including both initial and re-credentialing and follow up with practitioners as needed to obtain information for the credentialing process or as a result of mail being returned undeliverable to DentaQuest.
JOB DUTIES AND RESPONSIBILITIES:

  • Enter and maintain Provider applications, contracts and updates into the system.
  • Enter and maintain all Provider information into credentialing database.
  • Verify potential and existing Provider's licensure, liability insurance, BNDD, CDS and DEA certificate.
  • Verify Provider's education, hospital privileges, Board certification and other criteria as required.
  • Verify accurate banking & billing information.
  • Perform ongoing research tocorrect data so it does not create duplicate provider, locations, payees, and participations.
  • Maintain credentialing information by reviewing, entering and following up on missing information.
  • Review National Practitioners Data Bank for adverse charges pending or filed against Provider.
  • Track contract applications status.
  • Assure all files have a Welcome, Denial or Term Letter as appropriate.
  • Meet required turnaround times and accuracy rates.
  • Maintain fee schedules by creating, reviewing and auditing provider fees.
  • Keep up to date provider enrollment process and records and track provider participation levels.
  • Facilitate provider related research based on suspended claims, PO returns and other feedback opportunities.
  • Participation in credentialing committee as necessary.
  • Update the system and the credentialing database to reflect approvals, denials and/ or terminations.
  • Assist with other duties as assigned.
Skills & Requirements
JOB REQUIREMENTS:
  • High School diploma or equivalent, Associate's degree preferred.
  • 1-2 years of experience in business environment.
  • Previous experience working with files or the collection and coordination of data preferred.
  • Proficient in the use Excel required.
  • Experience with general computer software (Word, Outlook required).
  • Ability to learn new software programs quickly.
  • Good basic math skills.
  • Excellent customer service skills.
  • Excellent verbal and written communication skills.
  • Professional and effective interaction skills with co-workers, clients, Providers, vendors.
  • Proven ability to work well individually and as a team member.
  • Ability to prioritize and organize multiple tasks.
  • Ability to remain organized with multiple interruptions.
  • Ability to make independent decisions.
  • Strong attention to detail.
  • Strong business acumen.
  • Ability to adapt to constantly changing environment.
  • Ability to work in excess of 40 hours.

Careers
As one of the nation's leading oral health companies, we direct all our energy and resources to improving oral health in the communities we serve. We depend on our people for our ability to provide the highest-quality benefit programs and superior customer service. If you're looking for a challenging work environment where you will be asked to continually develop your skills, you've found the right place.
We are a growing, financially sound company with many advantages to offer to our employees. In addition to competitive salaries and a great benefits package, we also offer a stimulating, productive work environment. Work-life balance is a reality at DentaQuest, as is our commitment to our employees' career advancement.
DentaQuest is an equal opportunity employer. We believe that your work history is the best measure of the value you will bring to the company. We do not base any employment decision on a person's race, religion, color, national origin, gender, sexual preference, marital status, age, veteran status, or disability unrelated to the ability to do the job.
Thank you for visiting. We are delighted that you are considering joining our team of dedicated oral health professionals.

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