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Credentialing Jobs in Wisconsin (NOW HIRING)

Pimacounty

Court interpreter, Credentialed

Superior, WI

$27.19/hr

... Credentialing Program (ACICP). Essential Duties & Functions: * Interprets in consecutive and simultaneous modes English/Spanish and Spanish/English in hearings and proceedings for Superior, Juvenile ...

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$13

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$39

How much do credentialing jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for credentialing in Wisconsin is $24.59, according to ZipRecruiter salary data. Most workers in this role earn between $19.42 and $27.88 per hour, depending on experience, location, and employer.

How do you get into credentialing?

To enter credentialing, individuals typically need relevant education such as a healthcare or administrative degree, along with experience in healthcare administration or compliance. Certification programs like the Certified Provider Credentialing Specialist (CPCS) can enhance job prospects, and familiarity with credentialing software is often required. Entry-level roles may require strong organizational skills and attention to detail.

What is credentialing?

Credentialing is the process by which organizations verify the qualifications, experience, and professional standing of healthcare providers, such as doctors and nurses. This ensures that providers meet specific standards required to deliver care within a healthcare facility or insurance network. The process typically involves checking education, licenses, certifications, work history, and any disciplinary actions. Credentialing is essential for patient safety and regulatory compliance, and it is a key step before providers can practice or receive reimbursement from insurers.

Is credentialing a hard job?

Credentialing is a detail-oriented role that involves verifying qualifications, licenses, and certifications of healthcare providers or professionals. It requires strong organizational skills, attention to accuracy, and knowledge of industry standards, but the difficulty varies depending on the complexity of the credentialing process and the environment. Some find it challenging due to the administrative workload and compliance requirements, while others find it manageable with experience and proper tools.

What is the difference between Credentialing vs Medical Assistant?

AspectCredentialingMedical Assistant
Required credentialsCertifications, licenses, or accreditation for healthcare providersCertification (e.g., CMA), training programs, or on-the-job training
Work environmentHealthcare facilities, clinics, hospitals, insurance companiesDoctor's offices, clinics, outpatient facilities
Employer and industry usageUsed by healthcare providers and organizations to verify credentialsUsed by healthcare providers to assist with clinical and administrative tasks

Credentialing involves verifying healthcare providers' qualifications and licenses, ensuring they meet industry standards. Medical Assistants perform clinical and administrative duties under supervision. While credentialing focuses on verifying qualifications, Medical Assistants are involved in patient care and office tasks. Both roles are essential in healthcare but serve different functions.

What are the key skills and qualifications needed to thrive as a credentialing specialist, and why are they important?

To excel as a Credentialing Specialist, you need attention to detail, organizational skills, and knowledge of credentialing standards, usually supported by a relevant degree or experience in healthcare administration. Familiarity with credentialing software (such as CAQH or Verity), database management, and regulatory compliance systems is typically required. Strong communication, problem-solving abilities, and discretion stand out as essential soft skills in this role. These competencies ensure accurate provider verification, regulatory adherence, and smooth healthcare operations.

What are some common challenges faced by credentialing specialists when verifying provider information, and how can they be managed?

Credentialing specialists often encounter challenges such as incomplete or outdated provider documentation, slow response times from references, and varying requirements from different regulatory bodies. To manage these issues, it's important to maintain strong organizational skills, use credentialing software to track progress, and communicate clearly with providers about documentation needs and deadlines. Proactively following up and establishing checklists can help minimize delays and ensure compliance with industry standards.
What are the most commonly searched types of Credentialing jobs in Wisconsin? The most popular types of Credentialing jobs in Wisconsin are:
What are popular job titles related to Credentialing jobs in Wisconsin? For Credentialing jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Credentialing jobs in Wisconsin look for? The top searched job categories for Credentialing jobs in Wisconsin are:
What cities in Wisconsin are hiring for Credentialing jobs? Cities in Wisconsin with the most Credentialing job openings:
Credentialing jobs near you
Infographic showing various Credentialing job openings in Wisconsin as of July 2026, with employment types broken down into 86% Full Time, and 14% Part Time. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $51,139 per year, or $24.6 per hour.

Provider Credentialing & Contracting Coordinator

Group Helth Cooperative

Madison, WI • On-site

Other

Re-posted 16 days ago

Job description

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER
Full-time- 40 hours
Hybrid role - In-office training followed by a mix of work-from-home days and office days (2-3 days on site at the Administration Building)
Candidate must live in the Madison, WI area and be able to work on-site as needed.
The Provider Credentialing & Contracting Coordinator is responsible for supporting provider contracting, credentialing, and administrative functions at Group Health Cooperative of South Central Wisconsin. The primary focus of this role is assisting in negotiating and maintaining provider contracts, serving as the main contact for provider inquiries, overseeing contract setup and auditing, analyzing contracts for potential renegotiation and training providers in the use of self-service tools for insurance administration activities. In addition to contracting responsibilities, the specialist assists with the credentialing and recredentialing processes and ensures compliance with NCQA standards for Delegated Credentialing Agreements. The Provider Contracting and Credentialing Specialist will work under the guidance of the Chief Strategy and Business Development Officer.
JOB SPECIFIC MINIMUM QUALIFICATIONS

  1. Associate's or Bachelor's degree in business, healthcare administration or a related field or an applicable combination of education and work experience required. Bachelor's Degree preferred.
  2. Must be able to understand contract language and provider payment methodologies.
  3. Credentialing certificate preferred but not required. As a condition of employment, incumbent may be required to obtain certification within a reasonable time period.
  4. Knowledge of or ability to learn National Committee for Quality Assurance (NCQA) and/or Joint Commission on Health Care Organizations (JCHCO) standards required.
  5. Knowledge of and familiarity with medical terminology preferred.
  6. Strong interpersonal and communications skills and the ability to work effectively with a wide range of constituencies in a diverse community required. Ability to be culturally sensitive and to work with diverse populations.
  7. Strong customer service skills and the ability to maintain an excellent rapport with providers and their staff
  8. Time management skills and flexibility to work on multiple projects/assignments simultaneously, with ability to change focus as business needs dictate. Willingness to assume diverse duties and challenges
  9. Knowledge of and proven proficiency in the use of Microsoft Office applications including Word, Outlook, Excel and PowerPoint is required. Knowledge of and/or ability to learn and use computer based applications/software such as electronic time and attendance systems. Ability to use the Internet to obtain information and conduct research.
  10. Ability to build and maintain relationships with internal and external partners.
  11. Excellent written and verbal communication and interpersonal skills. Ability to speak and listen in person and in virtual meetings.
  12. Ability to maintain patient, employee and proprietary confidentiality required. Knowledge of or ability to learn HIPAA requirements.
  13. Ability to pay attention to detail required.
  14. Ability to work comfortably and routinely as part of a team and to cooperate across organizational boundaries.
  15. Professional manner necessary to deal courteously and effectively with customers and external partners.
  16. Possession of a valid Wisconsin Driver license with a good driving record. Access to transportation and ability to travel.
  17. Ability to maintain patient confidentiality required. Knowledge of medical records and appropriate documentation requirements. Knowledge of HIPAA requirements.

The incumbent knows and abides by all Group Health Cooperative of South Central Wisconsin (GHC-SCW) organizational and departmental policies, sets personal standards and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner.The incumbent understands our Mission, Vision, and Common Values (stated below) and is committed to promote these values in behavior and attitude.
Our Mission Statement:
We partner with members and the communities we serve to maximize health and well-being.
Our Vision:
As a local, not-for-profit, member-owned Cooperative, we are the most trusted resource for lifelong health and well-being in the communities we serve.
Our Values:
  • We are a not-for-profit Cooperative
  • We are member-centered
  • We are equitable and inclusive
  • We are quality-driven
  • We are innovative
  • We are community involved

GHC-SCW is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. GHC-SCW is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees, members, and patients feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard.
We believe:
Healthcare is a human right.
In treating all people with dignity and respect.
There is strength in diversity.
Equity celebrates our humanity.
We are better together.
Group Health Cooperative of South Central Wisconsin is proud to be an equal opportunity employer. GHC-SCW considers candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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