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Credentialing Specialist Jobs (NOW HIRING)

Anders

Credentialing Specialist

Chesterfield, MO · Remote

The Credentialing Specialist for the Credentials Verification Organization (CVO) at A5 Services is responsible for managing and verifying credentialing applications for initial appointments and ...

OrthoArizona

Credentialing Specialist

Peoria, AZ · On-site

Credentialing Specialist Our mission is to provide excellent, compassionate care to our patients, their families, and visitors. The responsibility of the Credentialing Specialist is to perform ...

OrthoArizona

Credentialing Specialist

Peoria, AZ

Credentialing Specialist Our mission is to provide excellent, compassionate care to our patients, their families, and visitors. The responsibility of the Credentialing Specialist is to perform ...

Addison Group

Credentialing Specialist

Houston, TX · Remote

$20 - $25/hr

Credentialing Specialist Location: Houston, TX - West Houston Industry: Healthcare / Credentialing & Provider Enrollment Pay: $20 - $25 / hour Benefits: This position is eligible for medical, dental ...

Anders

Credentialing Specialist

Saint Louis, MO · On-site +1

$48K - $62K/yr

The Credentialing Specialist for the Credentials Verification Organization (CVO) at A5 Services is responsible for managing and verifying credentialing applications for initial appointments and ...

OneOncology

Credentialing Specialist

Nashville, TN · On-site

The Credentialing Specialist will report to OneOncology's Credentialing Manager . The credentialing specialist is responsible for all aspects of the privileging and credentialing process for ...

LifeMD

Credentialing Specialist

$60K - $70K/yr

The Credentialing Specialist will ensure the efficient operation of medical licensing, credentialing, and payer contracts to maximize provider efficiency. Responsibilities * Credential/Re-credential ...

VeloSource

Be Seen First

Credentialing Specialist

Des Peres, MO · Remote

$60K/yr

We're seeking a detail-oriented Credentialing Specialist who thrives in a fast-paced environment and is passionate about delivering exceptional service. Position Summary The Credentialing Specialist ...

Distro

Credentialing Specialist

Salt Lake City, UT · On-site +1

Credentialing Specialist Department: Credentialing Reports To: Credentialing Manager Location: Salt Lake City, UT preferred (open to remote for the right candidate) Employment Type: Full-time ...

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Credentialing Specialist information

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How much do credentialing specialist jobs pay per hour?

As of Aug 23, 2026, the average hourly pay for credentialing specialist 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 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 the United States as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, and 2% Contract. Highlights an 79% Physical, 2% Hybrid, and 19% Remote job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Credentialing Specialist

Foothills Neurology PC

Phoenix, AZ • On-site

Full-time

Posted 25 days ago

Job description

Description:

Specific Role:

Credentialing Specialist

Reports To:

Revenue Cycle Manager


Job Description:

The Medical Credentialing Specialist supports Foothills Neurology’s Billing and Finance Department by managing all aspects of provider credentialing, payer enrollment, and re-credentialing. This position ensures that all physicians, nurse practitioners, and physician assistants are accurately credentialed and actively enrolled with contracted insurance plans to maintain uninterrupted reimbursement and compliance.

The ideal candidate is detail-oriented, self-motivated, and able to manage multiple credentialing timelines while maintaining thorough documentation and communication across departments.

Key Responsibilities

  • Prepare and submit initial credentialing, re-credentialing, and payer enrollment applications for all providers and practice locations.
  • Maintain up-to-date provider records, including licenses, DEA, NPI, board certifications, malpractice insurance, and CAQH profiles.
  • Track expirations, renewals, and re-attestation deadlines to ensure compliance with payer and regulatory requirements.
  • Conduct primary source verification and maintain accurate digital credentialing files.
  • Communicate directly with payers, providers, and internal departments to resolve application or enrollment issues.
  • Coordinate with HR during provider onboarding and terminations to ensure timely credentialing actions.
  • Collaborate closely with billing and revenue cycle teams to confirm provider enrollment aligns with payer rosters and reimbursement rules.
  • Prepare regular status reports and updates for leadership regarding pending applications, revalidations, and upcoming expirations.
  • Support audits, compliance checks, and payer correspondence as needed.
  • Stay updated on changes in managed care regulations and medical terminology to ensure best practices are followed.

Required Education:

  • Education: High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.

Required Experience:

  • Experience:
  • Minimum of 2 years of credentialing and/or payer enrollment experience in a healthcare or medical practice environment.
  • Knowledge of insurance payer processes, NCQA standards and accreditation processes, CAQH, NPPES/PECOS, and credentialing software systems.
  • Familiarity with CMS, commercial insurance, and Medicaid enrollment processes preferred.


Requested Qualifications/Skills:

  • Strong attention to detail and accuracy.
  • Excellent organizational and deadline management skills.
  • Professional written and verbal communication.
  • Ability to work independently and maintain confidentiality.
  • Proficiency in Microsoft Office (Word, Excel, Outlook).
Why Join Us

At Foothills Neurology, we value a culture of collaboration, service, and continuous improvement. As the Credentialing Specialist, you’ll play a pivotal role in shaping our billing operations and driving positive outcomes for our patients and our practice.

Requirements: