Credentialing Specialist Training and Certification Program Facts
A credentialing specialist works with healthcare facilities, performing duties such as developing and monitoring credentialing procedures for the institution, physicians or other service providers. Find out about the degrees, training and certification you'll need for this career.
What You Need to Know
As a credentialing specialist, you'd typically work with hospitals or other types of healthcare systems, either directly or through a credentialing agency. In this position, you might develop and implement credentialing procedures, maintain your institution's compliance with accreditation rules and regulatory statutes and credential physicians and other service providers. You'll also collect credentialing information, verify this information and maintain it in database format. In performing all of these tasks, you'll always help protect confidentiality and medical record privacy, as directed by the U.S. Health Insurance Portability and Accountability Act.
|Courses||Healthcare systems, human resources, ethics, financial management, legal issues in healthcare, health professions management, medical terminology, medical staff law, medical staff services and organizational behavior|
|Degrees||Associate of Applied Science in Medical Staffing; bachelor's and master's degree programs in health administration or public health|
|Certification||Earn certification via the National Association Medical Staff Services (NAMSS); Certified Professional Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) credential|
What Kind of Certification Might I Need?
Though not mandatory for employment, professional certification increases your marketability. To earn your certification as a credentialing specialist, you'll need to contact the National Association Medical Staff Services (NAMSS). Through the NAMSS, you can earn either the Certified Professional Medical Services Management (CPMSM) or the Certified Provider Credentialing Specialist (CPCS) credential. CPMSM certification requires you to have five years of work experience in the healthcare field, and CPCS certification requires at least three years of work experience.
What Will I Learn in an Associate's Degree Program?
As an aspiring credentialing specialist, you have a variety of educational options similar to those of other managers within the healthcare industry. Some healthcare organizations will expect you to have a master's degree, though an associate's degree program may prepare you for an entry-level position.
An Associate of Applied Science in Medical Staffing Services program can prepare you to sit for the CPMSM or CPCS examination. You may take courses such as:
- Medical terminology
- Healthcare statistics
- The legal aspects of medical staffing
- Organizational behavior for health systems
- Medical coding
- Medical quality management
These programs can be found in both on-campus and online formats.
Which Bachelor's and Master's Degree Programs Will Prepare Me for This Career?
You can pursue several kinds of healthcare information degrees at the bachelor's and master's degree levels to become a credentialing specialist; programs at both of these levels can also be found online. Some of the bachelor's degree programs you might pursue include health services administration, public health, and public health administration.
If you choose a master's degree program, you can look for programs accredited by the Commission on Accreditation of Healthcare Management Education or the Commission on Accreditation of Health Informatics and Health Information Management. Keep in mind that different master's degree programs have different requirements for the programs from which they'll accept students. Some will admit you with a degree in liberal arts or a health professional degree (such as nursing), while others will consider you if you have a healthcare administration or business degree.