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Credentialing Specialist in Pittsburgh, PA

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 applications.Verify licenses, certifications, education and work history for healthcare professionals.Conduct background checks and monitor compliance with accreditation standards.Maintain accurate credentialing records in databases and systems.Communicate with providers and internal teams to resolve credentialing issues.Prepare reports and documentation for audits and regulatory reviews.Ensure compliance with federal, state and payer requirements for credentialing.Track credentialing timelines and follow up to ensure timely completion.

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Salary for Credentialing Specialist in Pittsburgh, PA

45063 - 58710

Low
45063
The candidate is new to the role or has limited experience and is building necessary skills.
Mid
50213
The candidate has moderate experience in the role, meets most requirements or has equivalent transferable skills, and may also have relevant certifications.
High
58710
The candidate has extensive experience and advanced skills for the role, and may also have specialized certifications.
Projected salaries for related positions Job title Low Mid High Medical Coding Manager 67723 76478 87293 Certified Professional Coder 54590 62830 73645 Intake/Admissions Specialist 40685 43775 47123 Patient Access/Services Specialist 38883 42488 46093 Medical Customer Service Specialist 38110 41715 48153 Insurance Authorization Specialist 40170 41715 48153 Medical Scheduler 39140 41458 44290 Medical Data Entry Specialist 37338 40943 45578 Insurance Verification Specialist 38110 40685 47895 Insurance Referral Coordinator 37853 40428 46608 Electronic Medical Records Specialist 34505 36823 39913

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Our starting salary projections come from a rigorous, multistep process so that our numbers accurately reflect the marketplace. They are based on actual compensation for professionals Robert Half has matched with employers across the country and third-party job posting data from Textkernel that we use to independently validate the salary levels. Starting compensation—pay for someone new to a role—can vary significantly based on a candidate’s skills, experience and certifications, as well as other factors including industry, company size and revenue, and demand for the role. To reflect this variability, we report our salary data in three levels: low, mid and high.