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Credentialing Specialist Jobs in Port St Lucie, FL

OnSpot Dermatology

Credentialing Specialist

Stuart, FL · On-site

$25/hr

We are seeking a Credentialing Specialist to join our growing administrative team. This individual will play a vital role in supporting provider onboarding and compliance, ensuring that all ...

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$13

$24

$38

How much do credentialing specialist jobs pay per hour?

As of May 27, 2026, the average hourly pay for credentialing specialist in Port St. Lucie, FL 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 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 the key skills and qualifications needed to thrive as a Credentialing Specialist, and why are they important?

To thrive as a Credentialing Specialist, you need a strong understanding of credentialing processes, attention to detail, and familiarity with healthcare regulations, typically supported by a relevant associate’s or bachelor’s degree. Proficiency with credentialing software, databases, and document management systems is commonly required, along with knowledge of standards such as NCQA or Joint Commission. Exceptional organizational skills, effective communication, and the ability to manage deadlines help professionals excel in this role. These competencies ensure accurate provider verification and compliance, which are critical for patient safety and institutional accreditation.

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 are Credentialing Specialists?

Credentialing Specialists are professionals responsible for verifying the qualifications and backgrounds of healthcare providers and ensuring they meet the standards required by hospitals, insurance companies, and regulatory bodies. They collect, review, and process documentation such as licenses, certifications, education, and work history. Their work ensures that only properly qualified professionals are allowed to provide care, helping maintain patient safety and organizational compliance. Credentialing Specialists often work in healthcare facilities, insurance companies, or third-party credentialing organizations.

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.

More about Credentialing Specialist jobs
What cities near Port St. Lucie, FL are hiring for Credentialing Specialist jobs? Cities near Port St. Lucie, FL with the most Credentialing Specialist job openings:
Credentialing Specialist jobs near you

Credentialing Specialist

OnSpot Dermatology

Hobe Sound, FL • On-site

$25/hr

Full-time

Posted 25 days ago

Job description

We are seeking a Credentialing Specialist to join our growing administrative team. This individual will play a vital role in supporting provider onboarding and compliance, ensuring that all practitioners are properly credentialed and contracted with insurance payers.

Responsibilities:

  • Manage and maintain provider credentialing and recredentialing with commercial, Medicare, and Medicaid payers

  • Oversee contracting for new providers and ensure timely addition and removal of providers from payer rosters

  • Update and maintain provider information in CAQH, NPPES, and payer portals

  • Collaborate closely with the billing department to resolve credentialing-related issues impacting claims

  • Track and monitor credentialing status, expirations, and renewals to ensure compliance

  • Assist with provider enrollment and payer contract negotiations as needed

Qualifications:

  • Minimum 2 years of experience in medical credentialing (dermatology or multi-provider group experience preferred)

  • Strong understanding of insurance contracting, CAQH, Medicare, and Medicaid enrollment

  • Excellent organizational skills and attention to detail

  • Proficient with payer portals and credentialing software

  • Strong communication and problem-solving skills

Why Join OnSpot Dermatology:

  • Be part of an innovative, patient-centered mobile healthcare organization

  • Support a mission-driven team improving access to dermatologic care across Florida

  • Competitive compensation and benefits package