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Healthcare Credentialing Jobs (NOW HIRING)

Job Summary Our client is seeking a Credentialing Manager responsible for leading the design ... Experience with Salesforce Health Cloud or similar CRM and healthcare technology platforms.

VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. Role Summary As a Credentialing Specialist, you will help ensure the ...

Credentialing Specialist

Manhattan, NY · On-site

$58K - $65K/yr

VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.Role SummaryAs a Credentialing Specialist, you will help ensure the ...

Guide healthcare providers through initial credentialing and recredentialing submissions, ensuring all required materials are completed and returned within established timelines. * Examine ...

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Healthcare Credentialing information

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$38

How much do healthcare credentialing jobs pay per hour?

As of Sep 5, 2026, the average hourly pay for healthcare credentialing 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 healthcare credentialing?

Healthcare credentialing is the process of verifying the qualifications, experience, and professional background of healthcare providers, such as doctors, nurses, and other practitioners. This process ensures that healthcare professionals meet specific standards required by hospitals, insurance companies, and regulatory agencies. Credentialing typically involves validating education, training, licensure, certifications, and work history. It is essential for maintaining patient safety, regulatory compliance, and the quality of care within healthcare organizations.

What are the key skills and qualifications needed to thrive in healthcare credentialing?

To thrive in Healthcare Credentialing, you need meticulous attention to detail, a solid understanding of healthcare regulations, and experience with credentialing processes, often supported by a degree in healthcare administration or a related field. Familiarity with credentialing management software (such as CAQH or Verity), compliance databases, and knowledge of Joint Commission standards are typically required. Strong organizational skills, clear communication, and the ability to handle confidential information make candidates stand out. Mastery of these skills ensures accurate provider verification, regulatory compliance, and timely onboarding, all of which are vital for patient safety and institutional integrity.

What are some of the main challenges healthcare credentialing specialists face in maintaining up-to-date provider records?

Healthcare credentialing specialists often encounter challenges such as frequent changes in provider information, varying requirements from different insurance companies, and tight deadlines for credentialing renewals. Staying organized and maintaining accurate, up-to-date records is crucial, as incomplete or outdated information can delay provider onboarding or disrupt patient care. Effective communication with both providers and regulatory bodies is key to overcoming these hurdles, and many teams rely on specialized credentialing software to streamline the process and ensure compliance.

What is the difference between Healthcare Credentialing vs Medical Billing Specialist?

AspectHealthcare CredentialingMedical Billing Specialist
Primary FocusVerifying provider credentials and licensingProcessing insurance claims and payments
Required CertificationsCredentialing certifications, healthcare complianceBilling and coding certifications (e.g., CPC)
Work EnvironmentHospitals, clinics, insurance companiesMedical offices, billing companies
Industry UsageHealthcare administration, provider onboardingRevenue cycle management, billing departments

Healthcare Credentialing and Medical Billing Specialists both operate within healthcare administration but focus on different aspects. Credentialing ensures providers meet licensing standards, while billing specialists handle insurance claims. Understanding these differences helps clarify career paths and job roles in healthcare administration.

How to get into healthcare credentialing?

To enter healthcare credentialing, individuals typically need a high school diploma or equivalent, with some roles requiring a postsecondary certificate or associate degree in health administration or related fields. Gaining experience in healthcare settings and developing skills in attention to detail, organization, and knowledge of licensing and certification processes are important. Certification programs, such as the Certified Provider Credentialing Specialist (CPCS), can enhance job prospects and credibility in the field.

Is healthcare credentialing a hard job?

Healthcare credentialing can be challenging due to the detailed review of provider qualifications, compliance requirements, and the need for accuracy. It often requires strong organizational skills, attention to detail, and familiarity with healthcare regulations and credentialing software. The job may involve repetitive tasks and tight deadlines, but it is manageable with proper training and experience.
More about Healthcare Credentialing jobs

What cities are hiring for Healthcare Credentialing jobs?

Cities with the most Healthcare Credentialing job openings:

What states have the most Healthcare Credentialing jobs?

States with the most job openings for Healthcare Credentialing jobs include:

Infographic showing various Healthcare Credentialing job openings in the United States as of August 2026, with employment types broken down into 1% Locum Tenens, 2% As Needed, 66% Full Time, 16% Part Time, and 15% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Credentialing Lead -Healthcare (In Person)

Essen Medical Associates

Manhattan, NY • On-site

$80 - $100/hr

Other

Posted 14 days ago


Essen Health Care rating

4.6

Company rating: 4.6 out of 10

Based on 9 frontline employees who took The Breakroom Quiz


Job description

Overview

At Essen Health Care, we care for that!

As the largest privately held multispecialty medical group in the Bronx, we provide high-quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State. Guided by a Population Health model of care, Essen has five integrated clinical divisions offering urgent care, primary care, and specialty services, as well as nursing home staffing and care management. Founded in 1999, our over 20-year commitment has fueled an unwavering dedication toward innovating a better healthcare delivery system. Essen has expanded from a single primary care office to an umbrella organization offering specialties from women’s health to endocrinology, from psychiatry to a vast array of other specialties. All clinical services are offered via telehealth or in-person at over 35 medical offices and at home through the Essen House Calls program.

Essen Health Care is the place Where Care Comes Together! We are looking for the most talented and effective individuals to join our rapidly growing company. With over 1,100 employees and 400+ Practitioners, we care for over 250,000 patients annually in New York City and beyond. From medical providers to administration & operational staff, there is a career here for you. Join our team today!

Job Summary

The Credentialing Lead is responsible for Credentialing Committee Preparation, overseeing the complete lifecycle of provider credentialing, including file review, verification, committee preparation, and ongoing monitoring. This role ensures compliance with NCQA, TJC, CMS, State regulations, organizational policies, and delegated credentialing requirements. The Supervisor leads staff, manages workflows, ensures quality, and supports timely onboarding and committee readiness.

Responsibilities
  • Key Responsibilities

    Credentialing Committee & Compliance Oversight

    • Oversee preparation of credentialing packets for all meetings, ensuring accuracy, completeness, and regulatory alignment.
    • Present all files, terminations, meeting minutes, and new business items to the Credentialing Committee, ensuring materials are complete and compliant.
    • Manage agendas, meeting schedules, follow-ups, minutes, and voting documentation.
    • Collaborate with Medical Directors to finalize meeting materials, especially for red-flagged providers.
    • Oversee all delegated credentialing compliance requirements, including coordination of annual audits and preparation of semi-annual delegation reports, ensuring accuracy, timely submission, and adherence to regulatory and contractual standards.
    • Supervise the management of credentialing expirables, ensuring all licenses, certificates, and required documents are monitored, updated, and addressed in a timely and compliant manner.

    Application Review & Verification

    • Review all credentialing applications for completeness, log required information, and request missing documentation.
    • Critically evaluate applications for discrepancies, red flags, or quality of care concerns and elevate when appropriate.
    • Perform comprehensive primary source verification (PSV) for licensure, DEA, board certification, NPDB, education/training, malpractice history, and other required elements.
    • Track and follow up on all outstanding verifications to ensure timely completion.

    Monitoring & Compliance

    • Oversee monthly monitoring activities (licensing boards, OPMC, OMIG, OIG/SAM, Medicare OptOut) to ensure prompt identification and documentation of adverse actions.
    • Monitor the full credentialing lifecycle — initial appointment, reappointment, expirables, and ongoing monitoring — to ensure compliance with regulatory and delegated standards.
    • Ensure secure handling and confidentiality of all credentialing and committee materials.

    Leadership & Operational Oversight

    • Serve as a key liaison to Operations, People and Culture, and Malpractice Departments, ensuring seamless information‑sharing, timely updates, onboarding coordination, and collaboration on provider readiness and risk‑related matters.
    • Supervise and mentor Credentialing staff; monitor workload and performance standards.
    • Provide training on credentialing requirements, verification processes, and committee procedures.
    • Conduct file audits to ensure accuracy and quality.
    • Coordinate with onboarding staff, internal departments, and compliance teams to support provider readiness.
    • Prepare verification‑related payment requests.
    • Utilize credentialing databases to track status, outcomes and follow‑up tasks; prepare reports and dashboards for leadership.
Qualifications

Required

  • 3–5 years of healthcare credentialing or medical staff services experience.
  • 1–2 years of supervisory or team lead experience.
  • Strong knowledge of NCQA, TJC, CMS, and State regulatory standards.
  • Excellent attention to detail, organization, and ability to manage multiple priorities.
  • Strong communication skills and ability to work with executive and clinical leadership.

Preferred

  • Certified Notary - New York State
  • CPCS or CPMSM certification (or willingness to obtain).
  • Experience with credentialing systems (MD Staff, Medallion, Passport, MD Staff, Modio, etc.).

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

Position Type and Expected Hours to Work: Full-Time Position

Monday through Friday from 9:00 a.m. to 5 p.m. – 40 hours work week

Travel: No travel is expected or required for this position.

Supervisor Responsibility: As described above.

Equal Opportunity Employer

Essen Health Care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.

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