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Provider Credentialing Jobs (NOW HIRING)

ICONMA

Provider Credentialing Specialist

Detroit, MI · On-site

Provider Credentialing Specialist Our client, a health insurance company, is looking for a Provider Credentialing Specialist for their Detroit, MI / Hybrid location. Responsibilities: * Responsible ...

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Provider Credentialing information

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How much do provider credentialing jobs pay per hour?

As of Jul 10, 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.

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.
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Provider Credentialing jobs near you
Provider Credentialing Coordinator

Provider Credentialing Coordinator

Mindful Health Solutions

Houston, TX • On-site

Other

This job post has expired today. Applications are no longer accepted.

Job description

About the Role
We are seeking a detail-oriented and highly organized Provider Credentialing Coordinator to manage the credentialing, recredentialing, privileging, and payer enrollment processes for Psychiatrists, PMHNPs, and other healthcare providers.
This role ensures providers meet all regulatory, licensing, and payer requirements while maintaining accurate records and supporting ongoing organizational compliance. The position requires strong attention to detail, excellent follow-up skills, and experience working within healthcare credentialing workflows.
Key Responsibilities
Provider Credentialing & Compliance
  • Manage and track all phases of provider credentialing, recredentialing, privileging, and payer enrollment processes.
  • Ensure compliance with requirements from regulatory agencies, accreditation bodies, state licensing boards, and insurance payers.
  • Responsible for Data entry and maintaining provider information in online credentialing databases and system (Verifiable, CAQH, PECOS, and NPPES)
  • Serve as the primary point of contact for providers regarding credentialing and enrollment requirements.
  • Collect, verify, and maintain all required provider documentation (licenses, certifications, malpractice insurance, education, training, and work history).
  • Track license and certification expirations to ensure timely renewals and ongoing compliance.
  • Prepare, submit, and monitor credentialing and payer enrollment applications to ensure timely processing.
  • Follow up with licensing boards, insurance carriers, and external agencies to resolve application issues and expedite approvals.
  • Monitor application status and proactively follow up with payers until providers receive confirmation of in-network participation.
  • Responsible for revalidation requests issued by government payers
  • Maintain payer-specific credentialing knowledge, requirements, and application processes.
  • Identify and resolve discrepancies, delays, or incomplete credentialing applications.
  • Troubleshoot any payer-related issues
  • Provide regular status updates and reports on credentialing activities and provider enrollment progress.
  • Support audits, compliance reviews, and accreditation requirements as needed.
  • Identify process improvement opportunities to enhance credentialing efficiency and accuracy.
  • Ensure adherence to internal policies and external regulatory standards at all times.
  • Conduct research and verification activities to gather and validate provider information as needed.
Qualifications
Required Education and Experience
  • Bachelor's degree in Healthcare Administration, Business Administration, or related field preferred.
  • 2-3 years of experience in healthcare credentialing, provider enrollment, medical staff services, or related administrative function.
  • Direct experience with provider credentialing and payer enrollment required.
Skills and Competencies
  • Strong knowledge of healthcare credentialing standards, payer enrollment processes, and regulatory requirements.
  • Exceptional organizational skills and high attention to detail.
  • Experience using provider credentialing and enrollment platforms.
  • Preferred experience with Verifiable credentialing software.
  • Working knowledge of CAQH, Availity, and Provider Express.
  • Experience managing provider enrollment, credentialing, recredentialing, and payer-related documentation.
  • Familiarity with NCQA, Joint Commission, CMS, Medicare, and commercial payer requirements preferred.
  • Strong written and verbal communication skills.
  • Ability to manage multiple deadlines and priorities independently.
  • High level of confidentiality and professionalism when handling sensitive provider data.
  • Proficiency in Microsoft Office Suite (Outlook, Excel, Word, PowerPoint).
  • Strong problem-solving and follow-up skills in a fast-paced environment.

About Mindful Health Solutions:
Mindful Health Solutions is a leading outpatient psychiatry group dedicated to helping patients heal and thrive. We are transforming outpatient mental healthcare by providing advanced, evidence-based interventional treatments, including Transcranial Magnetic Stimulation (TMS), Esketamine therapy, and IV Ketamine Infusion Therapy. TMS is an effective, non-invasive, FDA-cleared treatment for drug-resistant depression. Esketamine is an FDA-approved prescription nasal spray for patients with treatment-resistant depression. Our IV Ketamine Infusion Therapy, an innovative treatment that helps stimulate new neural connections, restore balance in mood regulation, and provide rapid relief. Guided by nationally recognized clinical experts, we offer compassionate, comprehensive mental healthcare. Our clinics are designed to provide patients, practitioners, and employees with a modern, relaxed, and people-centered experience.
The pay range for this role is:
22 - 25 USD per hour (Houston)

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