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Credentialing Verification Specialist Jobs (NOW HIRING)

Anders

Credentialing Specialist

Chesterfield, MO · Remote

A5 Healthcare (Anders Affiliate) one of the fastest-growing Credentialing Verification Organizations in the country is seeking a Credentialing Specialist who is motivated to learn, excited to ...

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 ...

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How much do credentialing verification specialist jobs pay per hour?

As of Aug 26, 2026, the average hourly pay for credentialing verification 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 verification specialist?

A Credentialing Verification Specialist is responsible for verifying the credentials, certifications, and professional backgrounds of healthcare providers to ensure they meet industry standards and regulatory requirements. They review applications, contact licensing agencies, and confirm information such as education, work history, and certifications. Their role is essential for ensuring compliance with healthcare regulations and maintaining high standards of patient care.

What are the typical daily responsibilities of a credentialing verification specialist?

As a Credentialing Verification Specialist, your typical day involves reviewing and validating the qualifications of healthcare professionals, such as licenses, certifications, education, and work history. You will communicate with both providers and external agencies to gather necessary documentation and resolve discrepancies. The role also includes updating and maintaining credentialing databases, ensuring compliance with regulatory standards, and preparing reports for leadership or accrediting bodies. You’ll often collaborate closely with human resources, medical staff services, and administrative teams to support overall compliance and operational efficiency.

What are the key skills and qualifications needed to thrive as a credentialing verification specialist?

A Credentialing Verification Specialist needs strong attention to detail, organizational skills, and an understanding of medical credentialing processes, often supported by a relevant associate’s or bachelor’s degree. Familiarity with credentialing software (such as CAQH ProView, Verisys, or symplr), databases, and knowledge of regulatory standards like NCQA and Joint Commission is typically required. Excellent communication, problem-solving abilities, and the capability to manage tight deadlines set candidates apart in this role. These qualities ensure the accurate and efficient verification of credentials, which is crucial for maintaining compliance and smooth healthcare operations.

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Credentialing Verification Specialist jobs near you
Infographic showing various Credentialing Verification Specialist job openings in the United States as of August 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 78% Physical, 2% Hybrid, and 20% Remote job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Authorization & Insurance Verification Specialist

Peak Performance Physical Therapy

Lansing, MI • On-site

$17.25 - $21.25/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Join a team that puts people first and helps you rise
At Peak Performance Physical Therapy, your work matters to your patients, your team, and your future. We're committed to helping you reach your highest potential through mentorship, collaboration, and a culture built on compassion and excellence.
Who We are
A People-First Culture
Our story began with a simple belief: when people feel supported, they thrive. As part of a family of clinics dedicated to professional growth, clinical excellence, and real human connection, we foster an environment where you're valued, encouraged, and empowered to do meaningful work daily.
Our Purpose
Empowering lives through evidence-informed care
Our mission is to help people move freely, feel better, and live fully. Every member of our team contributes to breaking down barriers to care through prevention, education, and long-term recovery strategies. If you're passionate about making a real difference, you'll feel at home here.
About the role
Department: Billing
Status: Full-Time
Location: Lansing / Billing Department
Company: Peak Performance Physical Therapy
Peak Performance Physical Therapy is looking for a detail-oriented, dependable, and patient-focused team member to join our Billing Department as a Full-Time Authorization & Insurance Verification Specialist.
This role is an important part of the patient experience and overall revenue cycle process. The Authorization & Insurance Verification Specialist helps ensure patients are set up for care with accurate insurance information, timely authorizations, and clear communication between departments. This position supports our clinics, providers, intake team, and billing team by helping reduce delays in care and keeping patient accounts accurate from the start.
Position Summary
The Authorization & Insurance Verification Specialist is responsible for verifying patient insurance benefits, obtaining and tracking authorizations, maintaining accurate documentation, and communicating insurance-related information to the appropriate team members. This role requires strong attention to detail, follow-through, organization, and the ability to work collaboratively in a fast-paced healthcare environment.
What You'll Do
Responsibilities may include, but are not limited to:
  • Verify insurance eligibility and benefits for new evaluations, current patients, and upcoming appointments
  • Create and maintain accurate insurance benefit information in the patient record
  • Obtain required authorizations for physical therapy services
  • Track authorization status, visit limits, expiration dates, and payer requirements
  • Communicate authorization updates, benefit details, and potential barriers to the appropriate clinic or billing team member
  • Review schedules to ensure patients have the required insurance verification and authorization in place before treatment
  • Monitor authorization work queues, fax queues, payer portals, and related communication channels
  • Follow up with insurance companies, providers, and referral sources as needed
  • Document all insurance and authorization activity clearly and accurately
  • Support denial prevention by identifying missing or incorrect insurance information before claims are submitted
  • Assist with provider credentialing and recredentialing processes with commercial insurance carriers, government payers, and other contracted networks
  • Maintain and track provider credentialing records, applications, expirations, CAQH profiles, and supporting documentation
  • Support company and clinic credentialing needs, including payer enrollments, location updates, and ongoing participation requirements
  • Communicate with insurance payers regarding credentialing status, application follow-up, and enrollment requirements
  • Maintain accurate credentialing files and ensure timely submission of required documentation
  • Assist with billing department projects, payer updates, and process improvements as needed
  • Maintain patient confidentiality and follow HIPAA standards at all times

Qualifications
  • Previous experience in healthcare billing, insurance verification, authorizations, credentialing, patient accounts, or front office healthcare support preferred
  • Familiarity with insurance terminology, benefits, referrals, authorizations, deductibles, copays, coinsurance, visit limits, and payer enrollment processes preferred
  • Experience with provider credentialing, CAQH maintenance, payer portals, and insurance enrollment systems preferred
  • Experience with EMR systems, payer portals, fax queues, and Microsoft Office/Excel helpful
  • Strong written and verbal communication skills
  • Ability to maintain accuracy while working in a busy environment

What Makes Someone Successful in This Role
The right fit for this position is someone who is:
  • Highly organized and detail-oriented
  • Comfortable working with insurance information, payer portals, credentialing systems, and documentation requirements
  • Able to manage multiple tasks, deadlines, and follow-up items throughout the day
  • Strong in follow-through and communication
  • Comfortable asking questions and problem-solving when information is unclear
  • Team-focused and willing to support both the billing department and clinic operations
  • Patient-centered, even when working behind the scenes
  • Reliable, professional, and consistent

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