ZipRecruiter

Log In

1

Credentialing Specialist Jobs in Rio Rancho, NM (NOW HIRING)

VTP Holdings

Credentialing Specialist

Albuquerque, NM · On-site

The Credentialing Specialist is responsible for managing the credentialing process for members of the clinical team, ensuring all required documentation is complete, accurate, and compliant with ...

VTP Holdings

Credentialing Specialist

Albuquerque, NM · On-site

$20 - $24/hr

The Credentialing Specialist is responsible for managing the credentialing process for members of the clinical team, ensuring all required documentation is complete, accurate, and compliant with ...

VTP Holdings

Credentialing Specialist

Albuquerque, NM · On-site

$20 - $24/hr

The Credentialing Specialist is responsible for managing the credentialing process for members of the clinical team, ensuring all required documentation is complete, accurate, and compliant with ...

Chenega Corporation

Badging Specialist

Albuquerque, NM · On-site

Badging Specialist Chenega Sentinel 360 is seeking a Badging Specialist to support visitor control and credentialing operations at a government facility in Albuquerque, NM. This role is responsible ...

U.S. Navy

OPERATIONS SPECIALIST

Albuquerque, NM · On-site

Professional credentials and certifications * College credit hours toward a bachelor's or associate ... Specialist. Serving part−time as a Navy Reserve Sailor, your duties will be carried out during ...

U.S. Navy

RETAIL SERVICES SPECIALIST

Albuquerque, NM · On-site

As a Retail Services Specialist, you'll learn very quickly just how important the comforts of home ... Professional credentials and certifications * College credit hours toward a bachelor's or associate ...

next page

Showing results 1-20

All JobsCredentialing Specialist JobsCredentialing Specialist Jobs in Rio Rancho, NM

Credentialing Specialist information

See Rio Rancho, NM salary details

$12

$22

$36

How much do credentialing specialist jobs pay per hour?

As of Jul 14, 2026, the average hourly pay for credentialing specialist in Rio Rancho, NM is $22.91, according to ZipRecruiter salary data. Most workers in this role earn between $18.08 and $26.01 per hour, depending on experience, location, and employer.

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.

How much does a credentialing specialist make in the US?

A credentialing specialist in the US typically earns between $40,000 and $60,000 annually, depending on experience, location, and employer size. Salaries may increase with certifications such as Certified Provider Credentialing Specialist (CPCS) and proficiency in credentialing software. The role often requires attention to detail and knowledge of healthcare regulations.

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.

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 need for accuracy, managing multiple cases, and meeting deadlines, but it is generally manageable with proper training and experience.

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 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.

What is the role of a credentialing specialist?

A credentialing specialist is responsible for verifying and maintaining the credentials, licenses, and certifications of healthcare providers or other professionals to ensure compliance with industry standards and regulations. They manage documentation, coordinate with licensing boards, and use credentialing software to streamline the process, supporting the organization’s accreditation and quality assurance efforts.

What do you need to become a credentialing specialist?

To become a credentialing specialist, candidates typically need a high school diploma or equivalent, with some roles preferring an associate's or bachelor's degree in healthcare administration, business, or related fields. Relevant skills include attention to detail, knowledge of healthcare regulations, and experience with credentialing software or databases. Certifications such as Certified Provider Credentialing Specialist (CPCS) can enhance job prospects.
More about Credentialing Specialist jobs
What are the most commonly searched types of Credentialing Specialist jobs in Rio Rancho, NM? The most popular types of Credentialing Specialist jobs in Rio Rancho, NM are:
What are popular job titles related to Credentialing Specialist jobs in Rio Rancho, NM? For Credentialing Specialist jobs in Rio Rancho, NM, the most frequently searched job titles are:
What job categories do people searching Credentialing Specialist jobs in Rio Rancho, NM look for? The top searched job categories for Credentialing Specialist jobs in Rio Rancho, NM are:
What cities near Rio Rancho, NM are hiring for Credentialing Specialist jobs? Cities near Rio Rancho, NM with the most Credentialing Specialist job openings:
Credentialing Specialist jobs near you
Infographic showing various Credentialing Specialist job openings in Rio Rancho, NM as of July 2026, with employment types broken down into 100% Full Time. Highlights an 74% In-person, and 26% Remote job distribution, with an average salary of $47,656 per year, or $22.9 per hour.

Credentialing Specialist

VTP Holdings

Albuquerque, NM • On-site

Other

Posted 12 days ago

Job description

Job Summary:

The Credentialing Specialist is responsible for managing the credentialing process for members of the clinical team, ensuring all required documentation is complete, accurate, and compliant with Company and customer requirements. This role oversees credentialing activities across multiple healthcare facilities, including maintaining licenses, certifications, background checks, and other required documentation.

This is a fully remote position; however, candidates must reside within the posted hiring location(s). The ideal candidate is highly organized, detail-oriented, customer-focused, and comfortable managing credentialing processes independently while collaborating with internal teams, clinical leadership, healthcare facilities, and external customers.

Key Responsibilities:

  • Oversee and manage the credentialing process for clinical team members across multiple healthcare facilities.
  • Collaborate with Company's clinical leadership to establish and enforce appropriate credentialing documentation for all clinical team members.
  • Ensure that all required documentation is complete, accurate and up to date including licenses, certifications and background checks.
  • Maintain detailed records of credentialling activities and ensure compliance with healthcare regulations and standards.
  • Serve as a point of contact between healthcare facilities, the credentialing team, and vascular access nurse specialists to address inquiries and provide updates on credentialing statuses. Which may include billing clients after the credentialing service.
  • Collaborate with internal teams to streamline processes and ensure timely completion of credentialing tasks.
  • Coordinate with Company's customers to understand specific credentialing requirements and ensure all criteria are met.
  • Perform routine audits of credentialing files and take necessary actions to address any issues or discrepancies.
  • Provide exceptional customer service to both internal and external customers during the credentialing process.
  • Utilize Microsoft Office tools as needed (Word, Excel, Outlook) for documentation, reporting and communication.
  • Work with the clinical management team to schedule in-person orientations.
  • Place authorization orders for updates to clinical team member credentials.

Skills and Qualifications:

  • Strong organizational skills with the ability to manage multiple tasks and deadlines.
  • Excellent customer service and communication skills, both verbal and written.
  • Ability to work collaboratively with a team and external contacts.
  • Proficiency in Microsoft Office tools (Word, Excel, Outlook).
  • Understanding of healthcare processes and credentialing requirements.
  • Strong attention to detail and commitment to accuracy.
  • Ability to handle sensitive and confidential information with professionalism and discretion.

Apply