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Provider Credentialing Jobs in New York (NOW HIRING)

Network Temp Inc

Credentialing Specialist

Manhattan, NY · On-site

$30 - $32/hr

Review provider re-credentialing and credentialing file for completion and presentation to the Credentialing Committee. * Perform primary source verification on required elements and in accordance ...

Network Temp Inc

Credentialing Specialist

Manhattan, NY

$30 - $32/hr

Description Scope of Role & Responsibilities Maintain communication with the credentialing contacts at facilities and provider sites to coordinate receipt of information required for credentialing ...

ATD Technology LLC

Credentialing Specialist

New York, NY · On-site

$25 - $27/hr

The Credentialing Specialist is responsible for facilitating all aspects of provider credentialing, including initial appointment, reappointment, credential audits, as well as clinical privileging ...

ATD Technology LLC

Credentialing Specialist

New York, NY · On-site

$27 - $29/hr

The Credentialing Specialist is responsible for facilitating all aspects of provider credentialing, including initial appointment, reappointment, credential audits, as well as clinical privileging ...

ATD Technology LLC

Credentialing Specialist

New York, NY · On-site

$27 - $29/hr

The Credentialing Specialist is responsible for facilitating all aspects of provider credentialing, including initial appointment, reappointment, credential audits, as well as clinical privileging ...

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Provider Credentialing information

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How much do provider credentialing jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for provider credentialing in New York is $26.65, according to ZipRecruiter salary data. Most workers in this role earn between $21.06 and $30.24 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 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 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.

How to get into provider credentialing?

To enter provider credentialing, candidates 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. Familiarity with healthcare regulations and credentialing software is also beneficial.

Is provider credentialing hard?

Provider credentialing can be a complex process that involves verifying a healthcare professional’s qualifications, licenses, and work history, often requiring attention to detail and organization. It typically involves working with multiple organizations and adhering to specific regulations, which can make the process time-consuming and challenging for some providers. Strong communication skills and familiarity with credentialing software can help streamline the process.

What does a provider credentialing specialist do?

A provider credentialing specialist is responsible for verifying healthcare providers' qualifications, licenses, and certifications to ensure they meet the standards required by insurance companies and healthcare organizations. They manage the credentialing process, maintain accurate provider records, and ensure compliance with regulatory requirements, often using specialized credentialing software. This role requires attention to detail, knowledge of healthcare regulations, and strong organizational skills.

What are the most commonly searched types of Provider Credentialing jobs in New York?

The most popular types of Provider Credentialing jobs in New York are:

What are popular job titles related to Provider Credentialing jobs in New York?

For Provider Credentialing jobs in New York, the most frequently searched job titles are:

What job categories do people searching Provider Credentialing jobs in New York look for?

The top searched job categories for Provider Credentialing jobs in New York are:

Provider Credentialing jobs near you
Infographic showing various Provider Credentialing job openings in New York as of August 2026, with employment types broken down into 3% As Needed, 76% Full Time, 16% Part Time, and 5% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $55,429 per year, or $26.6 per hour.

PROVIDER CREDENTIALING SPECIALIST

C2Q Health Solutions

Bronx, NY • On-site

Full-time

Posted 7 days ago

Job description

JOB PURPOSE:The Provider Credentialing Specialist is responsible for managing provider credentialing, payer enrollment, and network participation activities for TeamCare Medical providers and practice locations. This role serves as the primary liaison between providers, insurance carriers, practice managers, and Finance to ensure timely credentialing, successful payer enrollment, and operational readiness. The Specialist supports the growth of the TeamCare Medical brand by expanding insurance network participation, maintaining strong payer and provider relationships, and coordinating the administrative processes necessary for providers and clinics to deliver and bill for services efficiently.
JOB RESPONSIBILITIES:
Provider Credentialing & Enrollment
  • Manage the full lifecycle of provider credentialing, recredentialing, and payer enrollment processes for physicians, nurse practitioners, physician assistants, and other licensed healthcare professionals.
  • Prepare, submit, and track credentialing applications with commercial insurance carriers, Medicare, Medicaid, and managed care organizations.
  • Complete and submit enrollment and revalidation for Medicare using PECOS system.
  • Monitor credentialing and enrollment statuses to ensure timely approvals and minimize delays in provider participation.
  • Maintain accurate provider records, licenses, certifications, malpractice insurance documentation, and other credentialing requirements.
  • Coordinate provider updates, demographic changes, and revalidation submissions with insurance carriers and regulatory agencies.
  • Ensure all credentialing activities comply with regulatory, payer, and organizational requirements.
  • Maintain and manage a database tracking expiration and renewal dates for all provider credentials, board certification, malpractice insurance coverage, CAQH re-attestations, and Medicaid and Medicare revalidation dates. Proactively notify providers so renewal processes can begin without disruption.
  • Maintain and manage providers' CAQH, including uploading and refreshing supporting documents ( licenses, DEA, malpractice COIs, W9s).

Practice & Network Expansion
  • Coordinate and manage the enrollment of new TeamCare Medical practice locations with insurance carriers and payer networks.
  • Serve as the primary administrative lead for adding clinics, service locations, and providers to payer networks.
  • Track payer applications, approvals, contracts, and implementation timelines for new locations.
  • Support initiatives that increase patient access and strengthen TeamCare Medical's presence within payer networks.

Payer Relations & Provider Support
  • Develop and maintain positive working relationships with insurance representatives, provider relations teams, and payer credentialing departments.
  • Serve as the primary contact for credentialing and enrollment inquiries from providers, practice managers, and insurance carriers.
  • Proactively resolve credentialing issues, application delays, network participation concerns, and enrollment discrepancies.
  • Assist providers and practice leadership in understanding payer requirements and credentialing expectations.
  • Promote a professional and responsive experience that supports provider satisfaction and organizational growth.
  • Act as the liaison between Finance, Medical Practice Managers, Revenue Cycle, and Medical Operations regarding payer enrollment and provider participation matters.
  • Coordinate communication related to billing activation, provider effective dates, claims issues, and payer updates.
  • Ensure provider and clinic information is accurately reflected across credentialing, billing, and operational systems.

Compliance & Reporting
  • Monitor upcoming credentialing expirations and recredentialing deadlines to ensure continuous participation with payers.
  • Maintain credentialing databases, files, and documentation in accordance with organizational policies and regulatory requirements.
  • Prepare reports and provide updates to leadership regarding credentialing activities, enrollment timelines, and payer relationships.
  • Participate in audits and regulatory reviews as required.
  • Recommend process improvements to enhance efficiency, reduce enrollment timelines, and improve provider onboarding.
  • Other duties as assigned.

Schedule: 8:30AM - 5:30PM
Weekly Hours: 40
QUALIFICATIONS:
Education:
  • Bachelor's degree in Healthcare Administration, Business Administration, Public Health, or equivalent years of experience.

Experience:
  • Minimum of 3 years of experience in healthcare credentialing, provider enrollment, payer relations, medical practice administration, or related healthcare operations.
  • Experience credentialing providers with Medicare, Medicaid, and commercial insurance carriers required.
  • Experience working with physician practices, clinics, or healthcare organizations preferred.
  • Experience managing multiple projects, deadlines, and payer relationships simultaneously.
  • Experience with provider enrollment platforms such as CAQH, PECOS, NPPES, and state Medicaid portals.

Physical Requirements
Individuals must be able to sustain certain physical requirements essential to the job. This includes, but is not limited to:
  • Standing - Duration of up to 6 hours a day.
  • Sitting/Stationary positions - Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods.
  • Lifting/Push/Pull - Up to 50 pounds of equipment, baggage, supplies, and ability to lift patients safely and using OSHA guidelines, etc.
  • Bending/Squatting - Must be able to safely bend or squat to care for patients, use medical supplies, etc.
  • Stairs/Steps/Walking/Climbing - Must be able to safely maneuver stairs, climb up/down, and walk to access work areas. Position requires the individual to be able to travel, and walk between sites/locations and work areas throughout the day.
  • Agility/Fine Motor Skills - Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools (ie. typing, use of medical supplies, equipment, etc.)
  • Sight/Visual Requirements - Must be able to visually assess patients, read orders type/write documentation, etc. with accuracy.
  • Audio Hearing and Motor Skills (language) Requirements - Must be able to listen attentively and document information from patients, community members, providers, etc., and intake information through audio processing with accuracy. In addition, must be able to speak comfortably and clearly with language motor skills for customers to understand the individual.
  • Cognitive Ability - Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job.

Disclaimer: Responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of the company.
We are an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, height, weight, or genetic information. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.
Salary Range (Min-Max):
$75,000.00 - $85,000.00
Every application is reviewed by our recruitment team. We do not use AI to make hiring decisions or automatically reject applicants. All employment decisions are based on job-related qualifications and applicable employment laws.

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