Credential Specialist Job Description, Duties, Responsibilities, Qualifications, Skills and Salary

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In this article, we will show you a detailed and updated Credential specialist job description. Here you will also find the duties of a Credential specialist job responsibilities, qualifications, skills, and estimated annual salary.

This Credential specialist job description template provides critical duties and responsibilities for the Credential specialist job. It’s ready to post on various job sites to assist you to recruit and hire people who will be responsible for keeping all providers current by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, commercial payers, Medicare, and Medicaid. As a job seeker, you can use this information to make a very rich resume and as well get yourself prepared for an interview.

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Credential Specialist Job Description

Credential specialist job description

A Credentialing Specialist, often known as a Physician Credentials Verification Coordinator, is a healthcare administrator who checks licences and credentials. Their responsibilities include maintaining extensive records on medical staff members, managing databases, and ensuring that staff members have the necessary legal licences and credentials to function in their respective disciplines.

The credentialing coordinator will organize, manage, and verify all components of the process, as well as keep updated practitioner files. You will keep track of certification expiration in order to keep files up to date, and you will answer phone calls from health plan providers and customers.

To be effective in this capacity, you must ensure that all information is current and accurate. Candidates must be dependable, enthusiastic, and have outstanding interpersonal skills.Credential specialist job description

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Duties of a Credential Specialist (Credential Specialist Job Duties)

  •  Maintain licensing, qualifications, and insurance records.
  • Investigate new state and federal regulations and practices.
  • When required by law, release information to inquiring agencies and public inquiries.
  • Assist in the development of internal credentialing processes.
  • Monitor license and credential expiration dates and notify employees of mandatory “renew by” dates.Credential specialist job description
  • Ensure that the facility and its employees are in conformity with regulatory and accrediting bodies

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Responsibilities of Credential Specialist (Responsibilities of a credential Specialist)

  • Capability to meet tight deadlines
  • Pay close attention to the details.
  • Excellent communication abilities
  • aware of policies, rules, and processes
  • Excellent computer skills
  • Database management expertise (if applicable)
  • Willingness to work as part of a team
  • Excellent organizational abilities
  • Create an efficient monitoring method/system for recording information on all staff members’ current certification, license, or credential information, as well as their expiration dates.
  • To gain services, training dates, and availability, communicate with external vendors who provide training, licencing, and certification.
  • Ensure that expired certificates and licences are renewed before the expiration date by notifying the medical professional of the expiration date and coordinating with them and external training providers to arrange dates and courses for the required credential.
  • Keep records of freshly renewed licences and certifications to avoid duplicates.
  • Book and confirm training with external providers, and ensure that medical professionals are aware of and able to attend any training that has been scheduled.
  • Obtain copies of all licenses/certifications and credentials and place them in the appropriate folder on the system.
  • Maintain internal databases and files today, both on the system and in hard copy.
  • Ensure that data is correctly stored and that data protection guidelines are followed.

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Qualifications for a Credential Specialist

  • A high school diploma or GED is required, as well as at least 5 years of experience directly related to the duties and responsibilities listed.
  • Degree(s) earned from an accredited institution that exceed the minimum education level may be substituted for experience on a year-for-year basis.


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Credential Specialist Job Skills

  • Ability to effectively communicate both vocally and in writing.
  • Customer service abilities.
  • Capability to respond to emails in a timely and effective manner.Credential specialist job description
  • Knowledge of how to do information searches.
  • Knowledge of the principles, regulations, methods, procedures, and paperwork governing medical provider credentialing and accreditation.
  • Working understanding of clinical and/or hospital procedures and operations.
  • Ability to make independent decisions and handle and disseminate confidential information.
  • Capability to preserve discretion and secrecy in all communications on behalf of credentialing applicants and/or applications.
  • Ability to make administrative/procedural decisions and decisions.
  • Advanced working knowledge of Microsoft Word and Excel is required.
  • To function well in a remote work environment, you must be able to master new apps.
  • Ability to define priorities and independently coordinate day-to-day issues.
  • Advanced knowledge of computer spreadsheets and database management.

Credential specialist job Salary

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The average credentialing specialist gross pay in the United States is $52,796 per year, or $25 per hour. They also receive an average bonus of $1,278. wage estimates are based on wage survey data from employers and anonymous employees in the United States. The average income for an entry-level credentialing specialist (1-3 years of experience) is $37,758. A senior level credentialing specialist (8+ years of experience), on the other hand, receives an average income of $65,204.


In Summary, a Credential Specialist Works for medical groups to guarantee that specialists and medical facilities are in compliance with rules. They must have strong communication skills because they must frequently communicate with insurance firms about changes in contracts and policies.

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