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How much do credentialing verification specialist jobs pay per hour?

As of Sep 2, 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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What are the most commonly searched types of Credentialing Verification Specialist jobs?

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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 1% As Needed, 83% Full Time, 14% Part Time, and 2% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Pharmacy Benefit Verification Specialist

Onco360

Pittsburgh, PA • On-site, Remote

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 14 days ago

Onco360 rating

7.7

Company rating: 7.7 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

20th of 113 rated pharmacies

Job description

Full-Time position may work remotely but MUST HAVE ACTIVE PENNSYLVANIA PHARMACY TECHNICIAN credentials from the State Board of Pharmacy.
Onco360 Pharmacy is looking for Pharmacy Benefit Verification Specialists for our Specialty Oncology Pharmacy.
As our company continues to grow, we strive to hire new team members with a passion for making a difference in our patient's lives.
Shift times are between 8am and 8pm.
**Starting salary at $24HR and up**
Sign-On Bonus: $5,000 for employees starting before September 30th, 2026.
We also offer quarterly incentive bonuses.
We offer a variety of benefits including:
  • Medical, Dental amp; Vision insurance
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Paid Volunteer Day
  • Floating Holiday
  • Referral Incentive
  • Paid Life, and short amp; long-term disability insurance
Pharmacy Benefit Verification Summary
The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.
Pharmacy Benefit Verification Specialist Major Responsibilities:
  • Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
  • Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.
  • Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
  • Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.
  • Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.
  • Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.
  • Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws
  • Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.
  • Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
Pharmacy Benefit Verification Specialist Qualifications:
  • Education/Learning Experience
    • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification
    • Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience
  • Work Experience
    • Required: 1+ years pharmacy or benefit verification experience
    • Desired: 3+ years pharmacy or benefit verification experience
  • Licenses/Certifications
    • Required: Pharmacy Technician License/Registration with Board of Pharmacy, as required by state law
  • Skills/Knowledge:
    • Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.
  • Behavior Competencies
    • Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill
Onco360 is a Closed door specialty pharmacy that focuses on patients who are currently undergoing cancer treatment. Our patients are important to us, so we always strive to meet and exceed their needs. We are seeking Pharmacy Benefit Verification Specialists who go above and beyond for our patients, and also passionate about helping others.

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