What Is a Certified Credentialing Specialist?

Explore the career requirements for certified credentialing specialists. Get the facts about education and licensure requirements, salary, and potential job growth to determine if this is the right career for you. Schools offering College Administration & Leadership degrees can also be found in these popular choices.

What Is a Certified Credentialing Specialist?

Certified credentialing specialists work at healthcare organizations, where they are in charge of making sure that the licenses and certifications of staff members are valid and stay up-to-date. To do so, they organize documents and keep track of upcoming renewal dates. As a renewal date approaches, they may advise employees about what they need to keep their designation current, such as earning continuing education credits. They also notify medical staff about upcoming changes to insurance contracts.

Check out the following chart to learn more about necessary job skills and certifications and possible earnings in this field.

Education Required High school diploma; associate's or bachelor's degree recommended
Education Field of Study Business administration
Certification Certification is optional, but may be preferred
Key Skills Detail oriented, organized, knowledge of health care laws
Job Growth (2014-2024) 17% (for all medical and health services managers)*
Median Salary (2017) $46,160(for all medical staff credentialing specialists)**

Sources: *U.S. Bureau of Labor Statistics, **Salary.com

Job Responsibilities for Certified Credentialing Specialists

A certified credentialing specialist--sometimes referred to as a Certified Provider Credentialing Specialist (CPCS)--is a type of health care worker. Credentialing specialists ensure that hospitals and other organizations within the health care industry are in compliance with accreditation standards and laws. As a credentialing specialist, you could also be in charge of checking the credentials and qualifications of staff members, such as physicians and nurses. You might work at a hospital, health clinic, health care organization or company that specializes in credential verification.

What Education Do I Need?

You'll typically need a high school diploma or GED to work as a credentialing specialist. Some employers may prefer applicants who hold an associate's degree or bachelor's degree; you might consider enrolling in a business administration associate's or bachelor's program. In these programs, you could take courses like human resources management, business ethics and performance evaluation. You can usually earn an associate's degree in two years, while a bachelor's program may take four years to complete.

Get Certified

Some employers prefer credentialing specialists who have obtained certification. You can earn the CPCS credential by taking an exam offered by The National Association Medical Staff Services (NAMSS). Additional requirements for the certification exam include current employment as an administrative medical service provider and at least three years of experience in the field.

To prepare applicants for the CPCS exam, the NAMSS provides a certification training course that covers regulations, application processes, physician licensing challenges, database management and file organization. The NAMSS notes that 27% of professional credentialing specialists received a pay raise as a direct result of getting certified (www.namss.org).

How Much Could I Earn?

According to Salary.com in February 2017, medical staff credentialing specialists in the 10th-90th percentile range earned an annual salary between $37,870 and $55,679. The median salary was reported as $46,160.

What Are Some Related Alternative Careers?

You might also be interested in a different managerial position in the health services industry. For example, as a clinical manager, you would oversee the activities of all staff within a medical facility or hospital department. You would also be responsible for ensuring that all staff activities are in compliance with medical industry standards and government regulations. Usually, you need to have a bachelor's degree for this job. Alternatively, you could become a health information technician, which involves managing medical information databases to make sure that all patient records are accurate and secure. To become a health information technician, you would need to complete a postsecondary training program.

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