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Provider Credentialing Jobs (NOW HIRING)

MetroPlusHealth

Credentialing Coordinator

Manhattan, NY · Hybrid

$50K - $58K/yr

This position is responsible for credentialing of new providers including Behavioral Health providers & facilities, re-credentialing, and processing provider demographic updates and changes. The ...

New

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 ...

Network Temp Inc

Credentialing Specialist

Manhattan, NY · On-site

$32/hr

Job Type Contract Description Scope of Role & Responsibilities • Maintain communication with the credentialing contacts at facilities and provider sites to coordinate receipt of information ...

Network Temp Inc

Credentialing Specialist

Manhattan, NY · On-site

$30 - $32/hr

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

ProviDRs Care

Credentialing Lead

Wichita, KS

$40K - $70K/yr

Oversee tracking and management of provider licenses, certifications, registrations, malpractice insurance, and other credentialing requirements. * Ensure timely renewals and prevent lapses that ...

New

ProviDRs Care

Credentialing Coordinator

Wichita, KS · On-site

Credentialing Coordinator Position Summary The Credentialing Lead is responsible for overseeing and executing complex provider credentialing activities across multiple states and payer networks. This ...

New

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 ...

ProviDRs Care

Credentialing Coordinator

Wichita, KS · On-site

Credentialing Coordinator Position Summary The Credentialing Lead is responsible for overseeing and executing complex provider credentialing activities across multiple states and payer networks. This ...

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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.
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
Credentialing Coordinator

Credentialing Coordinator

MetroPlusHealth

Manhattan, NY • Hybrid

$50K - $58K/yr

Full-time

Posted yesterday

New

MetroPlusHealth rating

7.8

Company rating: 7.8 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

163rd of 278 rated insurance

Job description

Position Overview

MetroPlusHealth is seeking an individual to join our Credentialing Department in the capacity of Credentialing Coordinator. This position is responsible for credentialing of new providers including Behavioral Health providers & facilities, re-credentialing, and processing provider demographic updates and changes. The Credentialing Coordinator is responsible for document collection, review, verification, and provider credentialing file maintenance. This position also ensures that all credentialing supporting documentation is confidential and maintained in a secure environment. Lastly, the Credentialing Coordinator assists facilities and providers in understanding and adhering to MetroPlusHealth’s policies and procedures regarding the credentialing process/provider information update.
Scope of Role & Responsibilities

  • Maintain communication with the credentialing contacts at facilities and provider sites to coordinate receipt of information required for credentialing, re-credentialing, and update of provider credentialing information
  • 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 regulatory guidelines and MetroPlusHealth’s policies and procedures
  • Data entry and upkeep of provider information in the credentialing and other pertinent databases
  • Verify New York State OPMC, Medicare/Medicaid lists and other pertinent databases for any current sanctions, restrictions on licensure and/or limitations on the scope of practice on all credentialed providers in interim credentialing periods
  • Verify New York State license registration and DEA registration status for all credentialed providers in the interim credentialing periods
  • Generate and disseminate monthly provider credentialing updates to appropriate departments at MetroPlusHealth and participating facilities and provider groups
  • Review and respond to request for credentialing information/copies of credentialing files to appropriate departments within MetroPlusHealth
  • Generate and disseminate provider rosters to delegated facilities, contracted group practices etc.
  • Perform provider roster reconciliation
  • Create, copy, file, and maintain all relevant documentation into provider credentialing folder.
  • Maintain confidentiality of provider credentials by filing the credentialing folder in respective cabinets in the file rooms.
  • Perform annual delegated file audits and participate in pre-delegation and delegation site reviews
  • Respond to inquiries from other MetroPlusHealth departments relative to a provider’s credentialing status
  • Performs other related tasks as directed by the Deputy Chief Operating Officer or her designee, the Credentialing Director or Credentialing Team Lead.

Required Education, Training & Professional Experience

  • Highschool Degree required; Bachelor’s Degree preferred
  • 3 years of previous experience with provider credentialing processes and procedures
  • Knowledge of CACTUS preferred
  • Must be able to handle multiple projects simultaneously.
  • Comprehensive knowledge of managed care with a specific emphasis on physician credentialing.
  • Ability to meet time-sensitive deadlines and multi-task in a changing healthcare environment.
  • Understanding of credentialing activities as they relate to initial credentialing, re-credentialing, and credentials modification(s).

Professional Competencies

  • Integrity and Trust
  • Customer Focus
  • Proficient in Microsoft Office (Word, Excel, Access)
  • Excellent communication (both verbal and written) and organizational skills

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