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Provider Credentialing Jobs in Ohio (NOW HIRING)

Beacon Talent

Credentialing Manager

Columbus, OH · Remote

$95K - $120K/yr

Manager of Credentialing (Healthcare) Location: Remote (US) or Hybrid (City, State) Type: Full-time ... Head of Operations / Director of Provider Operations (or similar) Comp: Competitive base + equity ...

DOCS, LLC

Provider Enrollment Specialist

Blue Ash, OH · On-site

Maintain a database for provider credentialing and update applicable software/systems as needed. * Perform detailed analyses of application and primary source verification information. * Identify ...

Elevance Health

Credentialing Analyst, Clinics

Columbus, OH · On-site

$23.70 - $39.10/hr

Maintains confidentiality of all pertinent pharmacy and provider information. * Administers credentialing and re-credentialing to ensure compliance with regulatory, accreditation and various managed ...

Armada Ltd

Credentialing Specialists

Cleveland, OH · On-site

Credentialing Specialists will provide credentialing service and support to operate IRS credentialing sites utilizing the GSA scheduling tool to manage credentialing appointments, run reports through ...

Armada Ltd

Credentialing Specialists

Cincinnati, OH · On-site

Credentialing Specialists will provide credentialing service and support to operate IRS credentialing sites utilizing the GSA scheduling tool to manage credentialing appointments, run reports through ...

Armada Ltd

Credentialing Specialists

Cincinnati, OH · On-site

Credentialing Specialists will provide credentialing service and support to operate IRS credentialing sites utilizing the GSA scheduling tool to manage credentialing appointments, run reports through ...

Armada Ltd

Credentialing Specialists

Cleveland, OH · On-site

Credentialing Specialists will provide credentialing service and support to operate IRS credentialing sites utilizing the GSA scheduling tool to manage credentialing appointments, run reports through ...

ZEPF CENTER

Revenue Cycle Assistant

Toledo, OH · On-site

Credentialing & Enrollment Support * Assist with provider credentialing, re-credentialing, and payer enrollment activities. * Assist with maintenance of provider demographic and enrollment data ...

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All JobsProvider Credentialing JobsProvider Credentialing Jobs in Ohio

Provider Credentialing information

See Ohio salary details

$13

$23

$37

How much do provider credentialing jobs pay per hour?

As of Jun 14, 2026, the average hourly pay for provider credentialing in Ohio is $23.16, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $26.30 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.
What are the most commonly searched types of Provider Credentialing jobs in Ohio? The most popular types of Provider Credentialing jobs in Ohio are:
What are popular job titles related to Provider Credentialing jobs in Ohio? For Provider Credentialing jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Provider Credentialing jobs in Ohio look for? The top searched job categories for Provider Credentialing jobs in Ohio are:
What cities in Ohio are hiring for Provider Credentialing jobs? Cities in Ohio with the most Provider Credentialing job openings:
Provider Credentialing jobs near you
Infographic showing various Provider Credentialing job openings in Ohio as of June 2026, with employment types broken down into 80% Full Time, 17% Part Time, and 3% Contract. Highlights an 92% In-person, and 8% Remote job distribution, with an average salary of $48,167 per year, or $23.2 per hour.
Billing & Credentialing Specialist

Billing & Credentialing Specialist

Caregiver Grove

Toledo, OH • On-site

Other

Posted 7 hours ago

Job description

Salary: $22

Position Overview

We are seeking a detail-oriented and proactive Billing & Credentialing Specialist to join our inclusive and affirming mental health practice. This role is critical to maintaining efficient revenue cycle operations by overseeing claims processing, client billing, and provider credentialing. The ideal candidate will have strong knowledge of Ohio Medicaid billing procedures, experience with third-party insurance, and the ability to manage credentialing processes from start to finish.


Key Responsibilities

Claims Processing & Revenue Cycle Management

  • Submit, correct, and track claims to ensure timely reimbursement.
  • Monitor claim status and manage rejections, denials, resubmissions, and appeals.
  • Address overpayments, underpayments, and recoupments within required timelines.
  • Process insurance write-offs in compliance with company policy.
  • Collaborate with third-party billing vendors (e.g., QualiFacts) to resolve escalated billing issues.
  • Maintain updated billing rules to improve efficiency.

Client Billing & Accounts Management

  • Verify insurance coverage monthly and ensure client demographic/insurance information is current in the EHR.
  • Respond promptly and professionally to client billing inquiries.
  • Manage accounts receivable, support collections, and document billing activity.
  • Maintain billing logs, internal notes, and compliance documentation.

Credentialing & Provider Enrollment

  • Manage credentialing and recredentialing for providers with Ohio Medicaid and private insurance carriers.
  • Track credentialing application statuses, revalidations, renewals, and provider rosters.
  • Ensure timely submission of all required paperwork and documentation.
  • Communicate with carriers to resolve credentialing or enrollment-related issues affecting billing.
  • Collaborate with providers and administrative staff to ensure smooth onboarding and compliance.

Compliance, Data Integrity & Reporting

  • Ensure compliance with Ohio Administrative Code (OAC), Ohio Revised Code (ORC), Medicaid requirements, and HIPAA standards.
  • Maintain EHR data hygiene, accuracy, and compliance (systems include inSync or CareLogic).
  • Support audits, compliance reviews, and credentialing-related billing checks.
  • Generate financial and credentialing reports to monitor performance, trends, and outstanding issues.


Qualifications

  • 23 years of experience in medical billing, credentialing, or revenue cycle management (behavioral/mental health preferred).
  • Strong understanding of Ohio Medicaid billing guidelines and third-party payer processes.
  • Experience managing provider credentialing and enrollment.
  • Proficiency in EHR systems such as inSync or CareLogic.
  • Knowledge of CPT/ICD-10 coding, insurance authorization, and HIPAA compliance.
  • Excellent organizational, communication, and problem-solving skills.
  • Ability to analyze data, identify trends, and recommend improvements.
  • High level of accuracy, attention to detail, and ability to meet deadlines in a remote environment.
  • Commitment to using inclusive, affirming, and culturally responsive language.