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Credentialing Specialist

Credentialing Specialist job description

The credentialing specialist manages the verification and maintenance of provider credentials to ensure compliance with regulatory standards and organizational policies. This role is responsible for processing applications, conducting background checks and maintaining accurate records for healthcare professionals.Working closely with providers, insurance companies and internal teams, the credentialing specialist ensures timely credentialing and recredentialing processes. This position plays a critical role in supporting patient safety, regulatory compliance and operational efficiency.

Typical credentialing specialist duties:

Review and process provider credentialing and recredentialing applicationsVerify licenses, certifications, education and work history for healthcare professionalsConduct background checks and monitor compliance with accreditation standardsMaintain accurate credentialing records in databases and systemsCommunicate with providers and internal teams to resolve credentialing issuesPrepare reports and documentation for audits and regulatory reviewsEnsure compliance with federal, state and payer requirements for credentialingTrack credentialing timelines and follow up to ensure timely completion

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National salary range for Credentialing Specialist

44500 - 57750

Low
44500
The candidate is new to the role or has limited experience and is still developing core skills.
Mid
49000
The candidate has moderate experience in the role or one similar, meets most requirements and may hold transferable skills or relevant certifications.
High
57750
The candidate has extensive experience in the role, demonstrates advanced skills and often brings specialized certifications or industry experience.
Projected salaries for related positions Job title Low Mid High Medical Coding Manager 66750 75750 86250 Certified Professional Coder 53500 61750 72250 Medical Customer Service Representative 42000 47500 53000 Insurance Authorization Specialist 41000 45250 49500 Intake/Admissions Specialist 40250 42750 46500 Patient Access/Services Specialist 38000 42000 45750 Medical Scheduler 38250 40500 43750 Medical Data Entry Specialist 36250 40000 44750 Insurance Verification Specialist 37500 42500 47500 Insurance Referral Coordinator 37000 40000 45750 Patient Registration Specialist 36750 42750 48000 Health Information Management Specialist 34750 39500 47000 Electronic Medical Records Specialist 33750 36000 39000

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The salary benchmarks in the Salary Guide From Robert Half are the result of a rigorous, multistep process designed to reflect projected market trends for 2027. They are based on actual compensation for professionals Robert Half has placed nationwide, along with third-party job posting data from Textkernel that we use for independent validation. Learn more about our methodology.