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Insurance Credentialing Specialist Jobs (NOW HIRING)

TeleMed2U

Credentialing Specialist

Austin, TX · Remote

$21 - $30/hr

Prepare and submit rosters to health insurance plans to ensure provider participation. * Update ... Credentialing Specialist II: * All Credentialing Specialist I responsibilities * Serve as a liaison ...

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Anders

Credentialing Specialist

Chesterfield, MO · Remote

The Credentialing Specialist for the Credentials Verification Organization (CVO) at A5 Services is ... and malpractice insurance. * Communicate timely updates to providers and member organizations ...

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Insurance Credentialing Specialist information

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How much do insurance credentialing specialist jobs pay per hour?

As of Jul 17, 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 are common challenges faced by Insurance Credentialing Specialists, 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 degree do you need to be a credentialing specialist?

A credentialing specialist typically needs at least a high school diploma or equivalent; however, many employers prefer candidates with an associate's or bachelor's degree in healthcare administration, business, or a related field. Relevant skills include attention to detail and knowledge of healthcare regulations, and certifications such as the Certified Provider Credentialing Specialist (CPCS) can enhance job prospects.

What does an insurance credentialing specialist do?

An insurance credentialing specialist is responsible for verifying healthcare providers' qualifications and obtaining necessary insurance network approvals. They manage provider enrollment, maintain accurate documentation, and ensure compliance with insurance requirements, often using credentialing software and maintaining detailed records.

How much does a credentialing specialist make in the US?

The average salary for an insurance credentialing specialist in the US is around $40,000 to $55,000 per year, depending on experience, location, and certifications. Many credentialing specialists work in healthcare offices or insurance companies, often requiring knowledge of payer requirements and credentialing software.

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.

What are the key skills and qualifications needed to thrive as an Insurance Credentialing Specialist, and why are they important?

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.

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 part of the job. The process can take several weeks to months depending on the insurer and completeness of submitted information.

What are Insurance Credentialing Specialists?

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.
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Insurance Credentialing Specialist jobs near you
Insurance Credentialing Specialist

Insurance Credentialing Specialist

Arbor Family Health

New Roads, LA

Full-time

Medical, Dental, Vision, Life, PTO

Posted 22 hours ago

Posted today

Job description

JOB DESCRIPTION

The Insurance Credentialing Specialist coordinates the credentialing, enrollment, recredentialing, and maintenance of healthcare providers with Medicare, Medicaid, commercial insurance carriers, and managed care organizations. This position ensures providers remain eligible for reimbursement by maintaining accurate provider records and regulatory compliance, including CAQH, NPPES, PECOS, and payer enrollment systems. The role also investigates and resolves credentialing- and enrollment-related claim issues to minimize reimbursement delays and ensure accurate payer processing.


REQUIREMENTS
  • High School Diploma or GED required; Associate's degree in Healthcare Administration or related field preferred.
  • Two years of provider credentialing experience required.
  • Experience with Medicare, Medicaid, commercial insurance enrollment, CAQH, NPPES, and PECOS.
  • Experience with Louisiana Medicaid/Gainwell and FQHC operations.

ABOUT THE COMPANY

Arbor Family Health is a Federally Qualified Health Center (FQHC) serving Pointe Coupee, West Baton Rouge and Iberville Parishes.

Benefits Include:

  • Competitive salary
  • Health, vision, dental and life insurance
  • Paid holidays and Paid Time Off
  • Continuing education support