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Director Of Credentialing Jobs in Delaware (NOW HIRING)

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Director Of Credentialing information

See Delaware salary details

$43.5K

$85.1K

$131.6K

How much do director of credentialing jobs pay per year?

As of Sep 12, 2026, the average yearly pay for director of credentialing in Delaware is $85,104.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,100.00 and $94,600.00 per year, depending on experience, location, and employer.

What does a director of credentialing do?

A Director of Credentialing oversees the process of verifying and maintaining the credentials of healthcare providers within an organization. This role ensures that all physicians, nurses, and allied health professionals meet the necessary licensing, certification, and regulatory requirements. The director manages credentialing staff, develops and updates policies, and coordinates with regulatory bodies to maintain compliance. They play a critical role in ensuring patient safety and organizational integrity by confirming provider qualifications.

What are the key skills and qualifications needed to thrive as a director of credentialing?

To thrive as a Director of Credentialing, you need in-depth knowledge of credentialing standards, healthcare regulations, and experience with provider enrollment, often supported by a degree in healthcare administration or a related field. Familiarity with credentialing software systems (such as CAQH or Verity), compliance management tools, and industry certifications like CPCS or CPMSM is typically required. Strong leadership, analytical thinking, and effective communication are crucial soft skills for managing teams and collaborating with providers and regulatory bodies. These competencies ensure the organization maintains regulatory compliance, reduces risk, and delivers efficient, high-quality credentialing services.

What are the primary challenges faced by a director of credentialing in maintaining compliance across multiple healthcare facilities?

A Director of Credentialing often manages credentialing processes for various providers and facilities, which can present challenges such as staying up to date with differing regulatory requirements, coordinating with multiple state and federal agencies, and ensuring all documentation is consistently accurate and complete. Effective communication with providers and internal teams is essential to prevent delays and mitigate risks of non-compliance. Additionally, adapting to frequent changes in accreditation standards and payer requirements requires a proactive approach and ongoing professional development.

What is the difference between Director Of Credentialing vs Credentialing Specialist?

AspectDirector Of CredentialingCredentialing Specialist
ResponsibilitiesOversees credentialing processes, manages teams, develops policiesPerforms credentialing tasks, verifies credentials, maintains records
Required CredentialsBachelor's degree, experience in credentialing, leadership skillsHigh school diploma or associate's, certification preferred, detail-oriented
Work EnvironmentHealthcare organizations, hospitals, clinicsMedical offices, healthcare facilities, credentialing departments

The main difference is that the Director Of Credentialing manages the entire credentialing department and develops policies, while the Credentialing Specialist handles day-to-day credential verification tasks. The director role involves leadership and strategic planning, whereas the specialist focuses on operational tasks.

What are popular job titles related to Director Of Credentialing jobs in Delaware?

For Director Of Credentialing jobs in Delaware, the most frequently searched job titles are:

What job categories do people searching Director Of Credentialing jobs in Delaware look for?

The top searched job categories for Director Of Credentialing jobs in Delaware are:

Director Of Credentialing jobs near you
Infographic showing various Director Of Credentialing job openings in Delaware as of August 2026, with employment types broken down into 2% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 2% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $85,104 per year, or $40.9 per hour.

Credentialing Specialist

New Castle, DE • On-site

Westside Family Healthcare, Inc.
Health Care and Social Assistance • 51 - 200 employees
Learn more about Westside Family Healthcare, Inc.external

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago

Job description

Job Type
Full-time
Description
WESTSIDE FAMILY HEALTHCARE IS LOOKING FOR A HEALTHCARE CREDENTIALING AND BILLING SPECIALIST TO JOIN THE REVENUE TEAM.
JOIN THE TEAM THAT CARES!
Westside Family Healthcare is a nonprofit organization that provides high quality primary medical care. The Healthcare Credentialing and Billing Specialist is primarily responsible for credentialing Licensed Independent
Providers (LIPs) with contracted insurance plans. The position supports the HRSA and Joint Commission compliant
initial and ongoing credentialing and privileging of all LIPs within the organization. This role provides broad
support to the Revenue Cycle department with a focus on credentialing, regulatory compliance, and patient billing related
tasks.
Since opening our doors in 1988, Westside has been driven by our mission to improve the health of our communities by providing equal access to quality healthcare. With 240 team members, five health centers, one mobile health unity and over 27,000 patients all across Delaware, Westside is committed to improving health, one patient, one family, one community at a time.
Our Mission: To improve the health of our communities by providing equal access to quality healthcare
Our Vision: Achieve health equity for all
Our Values:
  • Compassion: Lead with compassion
  • Service: Serve with humility
  • Excellence: Be exceptional
  • Empowerment: Empower all people

OUR BENEFITS: Our benefit package includes medical insurance (two plans to choose from), dental insurance (through Guardian Dental), vision insurance, life insurance paid by Westside with the option to purchase more paid, short term disability paid for by Westside, long term disability paid by the employee, a 401(k) retirement plan with a match, and supplemental insurances. We offer a generous PTO package and flexibility to provide work/life balance. Westside Family Healthcare is an Equal Opportunity Employer that values diversity.
CORE RESPONSIBILITIES
  1. Compile and maintain current credentialing and privileging data and records for all LIPs in accordance with established policies and procedures.
  2. Ensure that the LIP credentialing and privileging processes and policies comply with Joint Commission standards, HRSA and FTCA requirements.
  3. Ensure that all credentialing and privileging processes occur in a timely manner, including both initial and renewed privileges and monthly preparation of credentialing files for the Board of Directors.
  4. Generate, track, monitor and update all credentialing in established task tracking systems.
  5. Create custom reports for internal staff and vendors containing necessary provider data.
  6. As a member of the Provider Relations Team, work to support LIP and Family Medicine Residency onboarding, orientation, demographic updates, workflow updates and departures. Serve as a liaison between providers and Westside Family Healthcare leadership.
  7. Initiate, track and monitor all insurance credentialing for LIPs with all contracted insurance carriers. This includes creation and ongoing maintenance of CAQH profiles.
  8. Generate, track, monitor and update all provider insurance participation using established systems ensuring key staff and vendors can access required data appropriately.
  9. Notify appropriate personnel when providers are fully credentialed and contracted with each insurance company.
  10. Work closely with provider representatives from each insurance company to ensure that correct provider and practice information is on file, including demographic updates and verifications.
  11. Compile billing pool messaging according to established procedures, auditing billing pool messages to determine accuracy of requests and ensuring that third-party billing company takes appropriate actions.
  12. Process mail from all sites, which includes sorting documents and appropriately distributing them within the organization when necessary. This leads to the preparation of daily deposits including batching credit card payments received through the mail and uploading them securely to a third-party vendor for processing.
  13. Retrieve patient returned statement reports and update spreadsheets to send to appropriate staff on a weekly basis.
  14. Retrieve all medical and dental record requests from third-party billing company.
  15. Retrieve attorney billing requests received from Health Information Management Supervisor. Continuously update Attorney Billing Information Tracker and forward files to third-party billing company.
  16. Complete LabCorp and Quest demographic and diagnosis updates, as required.
  17. Provide updated eBrighthealth - ACO Monthly Provider Rosters while documenting each active provider's OIG verification.
  18. Provide updated monthly provider rosters to liability insurance agency/carriers.
  19. Reconcile patient roster reports from insurance carriers to ensure accuracy.
  20. Track and monitor insurance carrier participation by keeping up to date contracts on file, understanding all plans under carrier umbrellas and ensure Practice Management System is up to date with correct carrier information.
  21. Assist with data mining and data entry tasks within Value Based Data Entry Projects.
  22. Participates in process development and improvement initiatives within the Revenue Cycle Team.
  23. Other duties as assigned.

Requirements
  1. High school diploma or GED
  2. One year of experience in data entry or data entry training
  3. One year of experience using Microsoft Office software suite (Word, Excel, PowerPoint)
  4. Proven knowledge of, or experience using, medical billing principles.
  5. Experience with insurance contracting and credentialing
  6. One year of experience in healthcare provider credentialing and privileging

Apply