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Credentialing Specialist Jobs in Decatur, GA (NOW HIRING)

Armada Ltd

Credentialing Specialists

Atlanta, GA · On-site

YES, nationwide to support onsite credentialing operations as mission needs require.Security Clearance Required: N/ACONTINGENT UPON AWARDING OF GOVERNMENT CONTRACT*****Credentiali.

One Federal Solution

Credentialing Lead

Atlanta, GA

The Credentialing Lead will oversee credentialing operations at assigned locations or within an assigned geographic region, ensuring secure identity credential issuance, inventory accountability, and ...

One Federal Solution

Credentialing Lead

Atlanta, GA · On-site

The Credentialing Lead will oversee credentialing operations at assigned locations or within an assigned geographic region, ensuring secure identity credential issuance, inventory accountability, and ...

Aylo Health

Payor Enrollment Specialist

Atlanta, GA · Remote

The specialist works closely with providers, practice operations, credentialing staff, payors, and revenue cycle teams to monitor enrollment status, resolve issues, and maintain accurate provider ...

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All JobsCredentialing Specialist JobsCredentialing Specialist Jobs in Decatur, GA

Credentialing Specialist information

See Decatur, GA salary details

$13

$23

$38

How much do credentialing specialist jobs pay per hour?

As of Sep 7, 2026, the average hourly pay for credentialing specialist in Decatur, GA is $23.78, according to ZipRecruiter salary data. Most workers in this role earn between $18.80 and $26.97 per hour, depending on experience, location, and employer.

What is a credentialing specialist?

Credentialing specialists verify the qualifications of the staff in healthcare organizations for healthcare organizations. This verification process ensures that doctors and other medical professionals provide accurate education and work histories, and confirms that they meet all local and federal licensing and regulation requirements before they are hired or contracted with a medical facility. Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures. They also update medical databases with information about a physician’s training or license and document when credentials must be renewed.

What are some typical challenges a credentialing specialist faces when coordinating with healthcare providers and insurance companies?

Credentialing Specialists often encounter challenges such as managing incomplete or inconsistent provider documentation, meeting strict deadlines, and navigating varying requirements from different insurance companies or healthcare facilities. Effective communication and organizational skills are essential, as the role requires frequent follow-up with providers and close coordination with multiple internal departments. Staying updated on regulatory changes and ensuring all files remain compliant can also be demanding but is critical for maintaining smooth healthcare operations.

What is the difference between Credentialing Specialist vs Medical Biller?

AspectCredentialing SpecialistMedical Biller
Required CredentialsCertification in healthcare credentialing, knowledge of insurance and provider databasesCertification in medical billing, coding, or related areas often preferred
Work EnvironmentHealthcare facilities, insurance companies, or credentialing agenciesMedical offices, billing companies, healthcare providers
Employer & Industry UsageUsed in healthcare to verify provider credentials for insurance and licensingUsed in healthcare to process and submit medical claims for reimbursement

The Credentialing Specialist focuses on verifying healthcare providers' credentials to ensure compliance and eligibility, while the Medical Biller handles billing and claims processing for healthcare services. Both roles are essential in healthcare administration but serve different functions within the industry.

Is credentialing a hard job?

Credentialing specialists are responsible for verifying healthcare providers' qualifications and licenses, which requires attention to detail, organization, and knowledge of regulations. The job can be challenging due to the complexity of credentialing processes and the need for accuracy, but it is generally manageable with proper training and experience.
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Credentialing Specialist jobs near you
Infographic showing various Credentialing Specialist job openings in Decatur, GA as of August 2026, with employment types broken down into 85% Full Time, 11% Part Time, and 4% Contract. Highlights an 89% In-person, and 11% Remote job distribution, with an average salary of $49,466 per year, or $23.8 per hour.

Provider Enrollment and Credentialing Specialist

Ortho Sport and Spine Physicians

Atlanta, GA • On-site

Other

Posted 21 days ago

Job description

Description
Position Summary:
The Credentialing Specialist is responsible for managing all aspects of the credentialing, recredentialing, and privileging processes for providers delivering patient care within the clinic and Ambulatory Surgery Center (ASC). This role ensures that all providers and the ASC maintain active, compliant credentials and privileges with health plans, hospitals, and regulatory entities. The Specialist will maintain accurate provider data across credentialing databases and systems, ensure timely renewal of all required documents, and support organizational compliance with payer and agency requirements.
Key Responsibilities
Credentialing & Compliance
  • Maintain accurate and up-to-date credentialing data for all providers across internal databases and online systems.
  • Complete and manage provider credentialing and recredentialing applications, ensuring timely submission and proactive follow-up.
  • Ensure all provider documents-including state licenses, DEA certificates, malpractice coverage, and certifications-are current and compliant.
  • Maintain thorough understanding of evolving health plan, regulatory, and agency requirements.
  • Set up and maintain provider profiles in credentialing and payer enrollment systems.
  • Track all license, certification, malpractice, and DEA expiration dates to ensure timely renewals.
  • Ensure all practice and provider addresses are accurately reflected with health plans, agencies, and third-party entities.
  • Process and track hospital appointment and reappointment applications for provider privileges.
  • Audit health plan directories regularly to ensure accurate provider listings.
  • Maintain and update fee schedule contacts with insurance payers.
Billing & Enrollment Support
  • Apply working knowledge of medical billing and insurance claims rules as related to credentialing and payer enrollment.
  • Review EOBs to identify denial trends related to credentialing or enrollment issues.
  • Maintain and update CAQH profiles to ensure continuous payer compliance.
Other Duties
  • Perform additional responsibilities and special projects as assigned.
Qualifications
Education:
  • High school diploma or equivalent required.
  • Associate degree preferred.
Experience:
  • Minimum 2 years of credentialing or provider enrollment experience.
  • 1-2 years of medical billing and insurance follow-up experience preferred.
  • Experience with eClinicalWorks (eCW) preferred.
Skills & Competencies
  • Strong knowledge of credentialing and provider enrollment processes.
  • Excellent organizational skills with the ability to manage multiple priorities.
  • Exceptional attention to detail and accuracy.
  • Strong verbal and written communication skills, including professional correspondence.
  • Ability to analyze data, research discrepancies, and solve problems effectively.
  • Self-motivated with the ability to work independently with minimal supervision.
  • Ability to build and maintain positive working relationships with providers, leadership, and external partners.
  • Proficiency with Microsoft Office (Word, Excel, Access) and online credentialing systems.
  • In-depth understanding of medical billing rules and insurance claims processes.
  • Ability to review EOBs and identify credentialing-related denial patterns.
  • Extensive experience with CAQH management and upkeep.

Ortho Sport and Spine Physicians is an Equal Opportunity Employer and does not discriminate in its employment practices on the basis of race, religion, sex, color, national origin, age, disability, citizenship, genetic information, veteran status, military service, or any other characteristic protected by federal law or Georgia law.
Required Skills

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