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Provider Credentialing Jobs (NOW HIRING)

Qualifacts

Provider Credentialing Specialist

Tampa, FL · On-site +1

Responsibilities for the Provider Credentialing Specialist * Keeps abreast of regulatory developments in the Behavioral Health, Primary Care, and Medical Staff Services industries * Maintains ...

Qualifacts

Provider Credentialing Specialist

Tampa, FL · On-site +1

Responsibilities for the Provider Credentialing Specialist * Keeps abreast of regulatory developments in the Behavioral Health, Primary Care, and Medical Staff Services industries * Maintains ...

Fraser

Provider Credentialing Coordinator

Bloomington, MN · On-site

$20 - $25/hr

Fraser is seeking a Provider Credentialing Coordinator who will work closely with Fraser clinical staff to support the completion of credentialing materials. This role is responsible for efficiently ...

Fraser

Provider Credentialing Coordinator

Bloomington, MN · Hybrid

$20 - $25/hr

Fraser is seeking a Provider Credentialing Coordinator who will work closely with Fraser clinical staff to support the completion of credentialing materials. This role is responsible for efficiently ...

West Virginia University Health System

Coordinates the transition of all relevant provider credentials, licenses, degrees, privileges, and certifications upon signing of a new provider. Operational ownership of the centralized ...

West Virginia University Health System

Coordinates the transition of all relevant provider credentials, licenses, degrees, privileges, and certifications upon signing of a new provider. Operational ownership of the centralized ...

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Provider Credentialing information

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How much do provider credentialing jobs pay per hour?

As of Jun 12, 2026, the average hourly pay for provider 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 provider credentialing?

Provider credentialing is the process by which healthcare organizations verify and assess the qualifications, experience, and professional background of medical providers, such as doctors, nurses, and specialists. This includes checking education, training, licenses, certifications, work history, and any malpractice or disciplinary actions. Credentialing ensures that providers meet the standards required to deliver care and are eligible for participation in health insurance networks. It is a critical step for patient safety and regulatory compliance. The process must be repeated periodically to maintain up-to-date records and ensure ongoing eligibility.

Is credentialing a hard job?

Provider credentialing can be challenging as it involves verifying qualifications, licenses, and certifications, often requiring attention to detail and organization. The process can be time-consuming and may involve navigating complex regulations and documentation, but it is a standard part of healthcare administration. Success in the role depends on strong communication skills and familiarity with credentialing software and procedures.

How to get into provider credentialing?

To enter provider credentialing, individuals typically need a background in healthcare administration, medical billing, or related fields, along with strong organizational and communication skills. Gaining certification such as the Certified Provider Credentialing Specialist (CPCS) can enhance job prospects, and familiarity with healthcare databases and compliance standards is often required.

What jobs pay $10,000 a month without a degree?

Provider credentialing roles typically do not pay $10,000 a month without specialized experience or certifications. High-paying jobs that can reach this level without a degree often include sales, real estate, or skilled trades like plumbing or electrical work, which rely on experience, skills, and licensing rather than formal education.

What are some common challenges faced in a Provider Credentialing role, and how can they be managed?

A common challenge in Provider Credentialing is managing multiple deadlines and ensuring all documentation is accurate and up to date for various healthcare providers. The process often involves coordinating with providers, insurance companies, and regulatory bodies, which can lead to delays if communication is not clear. Staying organized, maintaining detailed records, and using credentialing management software can help streamline workflow and reduce errors. Building strong relationships with providers and team members also aids in resolving issues quickly and efficiently.

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

AspectProvider CredentialingMedical Billing Specialist
Required CredentialsLicenses, certifications, provider credentialsBilling certifications, coding knowledge
Work EnvironmentHealthcare facilities, insurance companiesMedical offices, billing companies
Employer & Industry UsageHospitals, clinics, insurance providersMedical practices, billing firms
Search & Comparison IntentUnderstanding credentialing process, requirementsBilling procedures, coding, reimbursement

Provider Credentialing focuses on verifying healthcare providers' qualifications to ensure they meet industry standards, while Medical Billing Specialists handle coding, billing, and reimbursement processes. Both roles are essential in healthcare operations but serve different functions within the industry.

What are the key skills and qualifications needed to thrive in Provider Credentialing, and why are they important?

To thrive in Provider Credentialing, you need strong attention to detail, organizational skills, and knowledge of healthcare regulations, typically supported by a background in healthcare administration or related fields. Familiarity with credentialing software, databases, and compliance tools such as CAQH ProView and state licensure systems is essential. Exceptional communication, problem-solving, and time management skills help professionals interact with providers and manage complex documentation processes. These competencies ensure accurate provider verification, regulatory compliance, and efficient onboarding, which are critical for healthcare organizations.

What jobs in the US pay 300,000 a year?

In provider credentialing, senior roles such as Credentialing Director or Manager can reach or exceed $300,000 annually, especially in large healthcare organizations. High-level healthcare executives, medical directors, and specialized physicians also often earn this level of compensation, typically requiring extensive experience, certifications, and leadership skills.
More about Provider Credentialing jobs
What cities are hiring for Provider Credentialing jobs? Cities with the most Provider Credentialing job openings:
What are the most commonly searched types of Provider Credentialing jobs? The most popular types of Provider Credentialing jobs are:
What states have the most Provider Credentialing jobs? States with the most job openings for Provider Credentialing jobs include:
What job categories do people searching Provider Credentialing jobs look for? The top searched job categories for Provider Credentialing jobs are:
Provider Credentialing jobs near you
Provider Credentialing Specialist

Provider Credentialing Specialist

Qualifacts

Tampa, FL • On-site, Remote

Full-time

Posted 16 days ago

Job description

Job Description:

Qualifactsis a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts' comprehensive portfolio, including the CareLogic, Credible, and InSync platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers.Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients. Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.

If you want to work inside an atmosphere where innovation has purpose, and your ambition works to support our customers and those they serve, please apply today!

We are seeking candidates in Nashville or Tampa to work a hybrid schedule in either office location. Remote candidates will not be considered.

Responsibilities for the Provider Credentialing Specialist

  • Keeps abreast of regulatory developments in the Behavioral Health, Primary Care, and Medical Staff Services industries
  • Maintains compliance with regulatory and accrediting bodies
  • Works collaboratively with leadership in the development and implementation of credentialing processes and procedures
  • Credentialing of physicians, allied health, and other practitioners
  • Insurance paneling of facilities, physicians, allied health, and other practitioners
  • Collects and maintains an accurate practitioner database and analyze verification information
  • Collects and maintains records in licenses, credentials, and insurance contracts
  • Monitors Partner/Customer's providers' credentials and licenses
  • Works collaboratively with Partners/Customers to advise on renewal procedures
  • Work collaboratively with Partners/Customers to ensure timely completion of credentialing processes
  • Releases information to agencies and members of the public as required by law
  • Escalates identified credentialing risks to Billing Manager and Partner/Customer leadership
  • Has a subject matter expertise level provider credentialing and processes
  • Develops and maintains credentialing processes and standards for the department
  • Keeps abreast of credentialing requirements for Joint Commissions and CARF
  • Keeps abreast of insurance paneling requirements for Medicare, Medicaid, and Commercial payers
  • Assists with the development and operations of a customer call center
  • Provides credentialing consultations/trainings as requested


Qualifications of Provider Credentialing Specialist

  • Proven experience in provider credentialing and insurance paneling
  • In-depth knowledge of industry's standards and regulations
  • Provider Credentialing Specialist certification through NAMSS preferred


Knowledge, Skills, and Abilities of the Provider Credentialing Specialist

  • Ability to delve into the credentialing requirements of Partners
  • Excellent communication and organizational skills
  • Motivation and ability to manage concurrent projects, constituents, and priorities with tight deadlines in a dynamic environment
  • Build positive and effective relationships with other leaders, internally and externally
  • Regarded as a team player by colleagues and models company values and culture
  • Ensures that all work adheres to company mission and goals
  • Represents the company, mission, and values well to both internal and external stakeholders

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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