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Insurance Credentialing Specialist Jobs (NOW HIRING)

LifeMD

Credentialing Specialist

$60K - $70K/yr

The Credentialing Specialist will ensure the efficient operation of medical licensing ... Maintain and update insurance credentialing and the CAQH Provider System * Maintain credentialing ...

Sunbelt Healthcare

Credentialing Specialist

Tucson, AZ · On-site

The Credentialing Specialist position requires an organized individual with good time management ... Professionalism in communication with clients, insurers, and industry contacts is a key component ...

Sunbelt Healthcare

Credentialing Specialist

Tucson, AZ · On-site

The Credentialing Specialist position requires an organized individual with good time management ... Professionalism in communication with clients, insurers, and industry contacts is a key component ...

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Insurance Credentialing Specialist information

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How much do insurance credentialing specialist jobs pay per hour?

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

Insurance Credentialing Specialists are professionals who manage the process of verifying and maintaining the qualifications of healthcare providers to ensure they meet the requirements of health insurance plans. Their primary role is to collect, review, and submit necessary documents to insurance companies so providers can participate in insurance networks and receive payment for their services. They also handle renewals and updates to keep credentials current and compliant. This role is vital for ensuring healthcare organizations and providers stay in good standing with insurers and avoid interruptions in billing or patient care.

What skills and qualifications are needed to be an insurance credentialing specialist?

To thrive as an Insurance Credentialing Specialist, you need strong attention to detail, organizational skills, and a solid understanding of healthcare regulations and credentialing processes, often supported by experience in medical administration or billing. Familiarity with credentialing software, CAQH ProView, and payer portals, as well as knowledge of compliance standards like NCQA or URAC, is typically required. Excellent communication, problem-solving abilities, and the capacity to manage multiple deadlines help professionals excel in this role. These skills ensure accurate provider credentialing, minimize delays in reimbursement, and maintain regulatory compliance for healthcare organizations.

What challenges do insurance credentialing specialists face, and how can they be managed?

Insurance Credentialing Specialists often encounter challenges such as navigating complex and varying requirements from different insurance payers, keeping up with changing regulations, and ensuring timely submission of documentation to avoid delays. Managing these challenges requires strong organizational skills, attention to detail, and effective communication with providers and payers. Utilizing credentialing software and maintaining a proactive approach to tracking deadlines can help streamline processes and reduce errors.

What is the difference between Insurance Credentialing Specialist vs Insurance Billing Specialist?

AspectInsurance Credentialing SpecialistInsurance Billing Specialist
Primary RoleVerifies provider credentials and secures insurance network participationProcesses insurance claims and manages billing for healthcare services
Required CertificationsKnowledge of credentialing processes, possibly certifications like Certified Provider Credentialing Specialist (CPCS)Knowledge of billing codes, insurance policies, and billing software
Work EnvironmentHealthcare offices, insurance companies, or credentialing firmsMedical offices, billing companies, or healthcare providers
Industry UsageCommonly used in healthcare provider credentialing and network enrollmentCommonly used in medical billing and revenue cycle management

The Insurance Credentialing Specialist focuses on verifying provider credentials and securing insurance network participation, while the Insurance Billing Specialist handles claims processing and billing. Both roles are essential in healthcare administration but serve different functions within the revenue cycle.

How do I become an insurance credentialing specialist?

To become an insurance credentialing specialist, you typically need a high school diploma or equivalent, along with knowledge of healthcare insurance processes. Many employers prefer candidates with experience in medical billing, coding, or healthcare administration, and some roles may require certification such as the Certified Provider Credentialing Specialist (CPCS). Strong organizational skills and familiarity with credentialing software are also beneficial.

How hard is it to do insurance credentialing?

Insurance credentialing for an Insurance Credentialing Specialist involves understanding insurance company requirements, completing detailed application processes, and maintaining accurate documentation. It requires attention to detail, organizational skills, and familiarity with healthcare regulations, but with training and experience, it becomes a manageable process. The difficulty can vary based on the complexity of insurance plans and the provider’s familiarity with credentialing procedures.

How much does an Insurance Credentialing Specialist make in the US?

An Insurance Credentialing Specialist in the US typically earns between $40,000 and $60,000 annually, with the average around $50,000. Salaries can vary based on experience, location, and the size of the organization, and the role often requires attention to detail and familiarity with insurance networks and credentialing processes.
More about Insurance Credentialing Specialist jobs

What states have the most Insurance Credentialing Specialist jobs?

States with the most job openings for Insurance Credentialing Specialist jobs include:

What job categories do people searching Insurance Credentialing Specialist jobs look for?

The top searched job categories for Insurance Credentialing Specialist jobs are:

Insurance Credentialing Specialist jobs near you
Infographic showing various Insurance Credentialing Specialist job openings in the United States as of August 2026, with employment types broken down into 74% Full Time, 13% Part Time, and 13% Contract. Highlights an 100% In-person job distribution, with an average salary of $50,665 per year, or $24.4 per hour.

Insurance Credentialing Specialist

Tampa, FL • On-site

BLACKSTONE MEDICAL SERVICES LLC
Health Care and Social Assistance • 51 - 200 employees
Learn more about BLACKSTONE MEDICAL SERVICES LLCexternal

Full-time

Re-posted 29 days ago

Job description

Job Title: Insurance Credentialing Specialist 

Status: Exempt- Full-Time (On-site) 

Location: Tampa, FL 

Company Overview 

Blackstone Medical Services is a leader in healthcare services, specializing in at-home sleep testing for sleep apnea. Our mission is to provide exceptional service to our clients while ensuring compliance and efficiency in all operations. 

Summary 

We are seeking a Credentialing Specialist to join our team at Blackstone Medical Services. In this role, you will be responsible for pursuing and initiating new healthcare contracts for a national sleep testing facility, maintaining current contracts, and ensuring compliance with industry standards and regulations. 

Responsibilities 

  • Oversee the credentialing process for new and existing health plans.
  • Verify provider credentials, including education, training, and licensure.
  • Maintain accurate records and documentation of all credentialing activities.
  • Ensure compliance with federal and state regulations as well as organizational policies.
  • Collaborate with medical staff and administrative teams to facilitate timely credentialing.
  • Monitor expiration dates of licenses and certifications to ensure ongoing compliance.

Requirements 

  • Proven experience in managed care or medical credentialing preferred.
  • Strong understanding of medical terminology and healthcare standards.
  • Excellent organizational skills with attention to detail.
  • Ability to communicate effectively with diverse stakeholders.
  • Experience in a medical office setting is a plus.

If you are passionate about ensuring quality in healthcare services and have the skills to excel as a Credentialing Specialist, we invite you to apply today and become part of our dedicated team at Blackstone Medical Services! 

EEO Statement 

Blackstone Medical Services is an Equal Employment Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and employees without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law. 


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