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Credentialing Representative Jobs (NOW HIRING)

Specialtycare

Credentialing Representative

Brentwood, TN · Hybrid

$48K/yr

Job Summary The Credentialing Representative is part of a collaborative team, and has the flexibility to work on a hybrid schedule in Brentwood,TN. We offer a pay increase after 90 days of employment ...

Specialy Care

Credentialing Representative

Brentwood, TN · On-site

$48K/yr

Job Summary The Credentialing Representative is part of a collaborative team, and has the flexibility to work on a hybrid schedule in Brentwood,TN. We offer a pay increase after 90 days of employment ...

Specialy Care

Credentialing Representative

Brentwood, TN · On-site

$48K/yr

Job Summary The Credentialing Representative is part of a collaborative team, and has the flexibility to work on a hybrid schedule in Brentwood,TN. We offer a pay increase after 90 days of employment ...

HealthONE

Credentialing Representative

Dalton, GA · On-site

Credentialing Representative The Credentialing Representative is responsible for the credentialing and recredentialing of providers in compliance with NCQA, CMS, DOI, state credentialing standards ...

SpecialtyCare

Credentialing Representative

Brentwood, TN · On-site

$48K/yr

Credentialing Representative SpecialtyCare is a leading provider of clinical services to hospitals. We partner with hospitals to drive, sustain, and accelerate high performance. We offer a portfolio ...

Triwest Healthcare

Provider Credentialing Rep

The Provider Credentialing Representative plays a key role in driving operational efficiency, ensuring that performance metrics and production goals are consistently achieved while maintaining ...

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How much do credentialing representative jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for credentialing representative in the United States is $24.36, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $27.64 per hour, depending on experience, location, and employer.

What is a credentialing representative?

Credentialing Representatives are professionals responsible for verifying and processing the qualifications and credentials of healthcare providers, such as doctors, nurses, and other practitioners. They ensure that providers meet all regulatory, organizational, and insurance requirements before they can deliver care or bill for services. This role involves collecting and reviewing documents, conducting background checks, and maintaining up-to-date records to comply with industry standards and legal guidelines.

What are some common challenges faced by credentialing representatives, and how can they be addressed?

Credentialing Representatives often encounter challenges such as managing tight deadlines, navigating complex and varying requirements from different healthcare organizations, and ensuring the accuracy of provider documentation. To address these, it's important to develop strong organizational skills, maintain open communication with providers and internal teams, and stay updated on regulatory changes. Many organizations provide training and support to help representatives stay compliant and efficient in their roles.

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

To thrive as a Credentialing Representative, you need strong attention to detail, organizational skills, and a solid understanding of healthcare credentialing processes, often supported by an associate degree or relevant experience. Familiarity with credentialing software, databases, and compliance standards such as NCQA or Joint Commission is typically required. Excellent communication, problem-solving abilities, and discretion are vital soft skills for managing sensitive information and coordinating with providers and regulatory bodies. These skills are crucial for ensuring timely, accurate credentialing, maintaining regulatory compliance, and supporting quality patient care.

What is the difference between Credentialing Representative vs Medical Billing Specialist?

AspectCredentialing RepresentativeMedical Billing Specialist
Required credentialsHigh school diploma; certifications like Certified Provider Credentialing Specialist (CPCS) are commonHigh school diploma; certifications like Certified Medical Billing Specialist (CMBS) are common
Work environmentHealthcare facilities, insurance companies, credentialing organizationsMedical offices, billing companies, healthcare providers
Employer usageHospitals, clinics, insurance providersMedical practices, billing firms, healthcare networks
Common search intentUnderstanding credentialing processes, certification requirementsBilling procedures, coding, reimbursement processes

The Credentialing Representative primarily manages provider credentialing and licensing, ensuring compliance with industry standards. In contrast, a Medical Billing Specialist focuses on processing claims, coding, and reimbursement. While both roles work within healthcare administration, their responsibilities and skill sets differ significantly, making this comparison useful for those exploring healthcare support careers.

How to become a credentialing representative with no experience?

To become a credentialing representative with no experience, focus on developing organizational and communication skills, and consider completing relevant training or certification programs in healthcare administration or credentialing. Entry-level positions often require a high school diploma or equivalent, and on-the-job training is common to learn specific processes and software used in credentialing. Gaining familiarity with healthcare regulations and documentation can also improve your chances of starting in this role.

Is credentialing a hard job?

Credentialing representatives are responsible for verifying healthcare providers' qualifications and licensing, which requires attention to detail, organization, and knowledge of industry regulations. The job can be challenging due to the need for accuracy, managing multiple cases, and meeting deadlines, but it is generally manageable with proper training and experience.
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Credentialing Representative jobs near you
Infographic showing various Credentialing Representative job openings in the United States as of August 2026, with employment types broken down into 86% Full Time, 12% Part Time, and 2% Contract. Highlights an 64% Physical, 1% Hybrid, and 35% Remote job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Credentialing Representative

Brentwood, TN • Hybrid

Specialtycare

5.4

Company rating: 5.4 out of 10

Based on 24 frontline employees who took The Breakroom Quiz

People enjoy working here

Good training

Learn more about Specialtycareexternal

$48K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 23 days ago

Job description

Passionate, driven people dedicated to making a difference in healthcare.

SpecialtyCare is a leading provider of clinical services to hospitals. We partner with hospitals to drive, sustain, and accelerate high performance. We offer a portfolio of solutions that include neuromonitoring, perfusion, surgical assist, autotransfusion, minimally invasive surgical support, and sterile processing. SpecialtyCare's clinicians focus their efforts to improve operational efficiencies, improve outcomes, and maintain exceptional levels of satisfaction. We compete on results.

Job Summary

The Credentialing Representative is part of a collaborative team, and has the flexibility to work on a hybrid schedule in Brentwood,TN. We offer a pay increase after 90 days of employment and successful completion of training. SpecialtyCare also offers a comprehensive benefit plan which includes, medical, dental, vision and life insurance. We have a matching 401k and generous PTO plan. We also provide continuing education and professional development reimbursement.

To learn more about what a "day in the life" would look like, please follow the link to read what one of our Senior Credentialing Representatives has to say about what she does:

A Day in the Life of a Credentialing Representative

The primary role of this position is the collection and maintenance of all information for associate credentialing files for meeting the Joint Commission requirements for the Health Care Staffing Services certification or Joint Commission Accreditation for Ambulatory Health. 

  • Processes and maintains the confidential credentialing files for each associate; including evaluation for completeness.  
  • Collaborates with clinical management and credentialing staff to obtain missing information as needed.
  • Completes accurate and timely data entry into the credentialing database program (Verity) to ensure all associate files are up to date.
  • Replies timely to all requests for credentialing items and/or inquiries from operations and hospital clients.
  • Completes credentialing file requests for outlying facilities.
  • Basic office functions such as phones, mail, filing, and copying
  • Other duties as assigned.

The Successful Candidate

The successful candidate must bring a high level of ethical, intellectual, professional and personal values that complement the team and company vision.  The following competencies are highly valued:

  1. Get Results - Able to demonstrate high personal work standards and a sense of urgency about results; do everything possible to meet goals and deadlines; persist in the face of repeated challenges; accept responsibility for the outcomes of their own work.
  2. Problem Solving and Analysis - Able to gather appropriate data and diagnose the cause of a problem before taking action; separate causes from symptoms; apply lessons learned from others who encountered similar problems or challenges; anticipate problems and develop contingency plans to deal with them; develop and evaluate alternative courses of action.
  3. Flexibility and Change - Able to positively deal with changes that affect job requirements; adapt to shifting priorities in response to the needs of internal and external clients; quickly recognize situations/conditions where change is needed; work to clarify situations where information, instructions, or objectives are ambiguous; support organizational change.
  4. Attention to Detail - Able to review data/documents for accuracy and consistency; take action to prevent mistakes; follow procedures closely; keep records accurate and up to date; test services/applications rigorously when needed.
  5. Relationship Building - Able to establish personal standards of quality for own work; independently improve the quality of own work processes, products, and/or services; identify and apply "best practices" in own work; improve the efficiency of own work by eliminating barriers and streamlining work processes; measure and track own performance.

Salary starts at $45,000 and then advances to $48,000 after 90 days of employment.

SpecialtyCare is an Equal Opportunity and Affirmative Action Employer

Employment with SpecialtyCare is at-will

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