How Do I Become a Credentialing Specialist?

Research what it takes to become a credentialing specialist. Learn about the education requirements, job duties and salary to find out if this is the career for you. Schools offering College Administration & Leadership degrees can also be found in these popular choices.

What Is a Credentialing Specialist?

A credentialing specialist is a human resources worker at a medical facility who is in charge of making sure that the licenses of doctors, nurses and other healthcare workers stay valid and up-to-date. They organize and maintain licensure records. When renewal dates are coming up, they contact the affected healthcare worker and advise them about what they need to do to keep their license valid, such as earning continuing education credits and filling out necessary paperwork.

Check out the list of general requirements for a career as a credentialing specialist in the table below.

Education Required Varies by institution, minimum of high school diploma with experience, associate degree in related field preferred, bachelor's degree required in some facilities
Key Responsibilities Verifying health care professionals' resumes, record keeping and report writing, staying aware of changing regulations and policies, notifying proper authorities as necessary
CertificationCertification may be required
Job Growth (2014-2024)5% (for all human resource specialists)*
Median Salary (2017)$41,724**

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

What Does a Credentialing Specialist Do?

The credentialing process includes checking a professional's licenses, work experience, degrees, training, disciplinary history and letters of recommendation to determine his or her skills and experience. This process helps to ensure that healthcare professionals employed at hospitals, clinics and other medical facilities are properly educated, trained and qualified.

As a credentialing specialist, your job duties include using computer programs to check qualifications, logging data, keeping records and creating reports. It is common for this position to require working under strict deadlines to complete the credentialing process. You are required to stay informed about credentialing regulations and applicable laws. It may also be part of your job to send notifications about your findings to the proper staff members.

What Education Is Required?

Education requirements for this position vary, according to job ads found on various college and university websites for credentialing specialist positions at school medical facilities in May 2011. Some employers may only require a high school diploma, and some may prefer you to have an associate degree in a medical-related field. Typically, employers requiring only a high school diploma also require work experience in the field.

Associate degree programs in medical staff services may be useful for individuals hoping to enter this career. They offer education in credentialing and medical office procedures. Courses may cover topics in medical terminology, health care law, medical billing and coding, anatomy, keyboarding and credentialing procedures.

What Else Do I Need to Do to Prepare for this Career?

Experience working in a medical office, as a medical secretary is often required by employers, according to the college and university medical center job ads. You may also need to have excellent communication and computer skills.

Some employers may want you to be a Certified Provider Credentialing Specialist (CPCS). The CPCS certification is offered through the National Association Medical Staffing Services and is available if you meet employment experience requirements (www.namss.org). You must also pass the CPCS exam, which covers topics on credentialing procedures, source verification, regulation standards and documentation procedures.

What Are Some Related Alternative Careers?

Instead of working as a credentialing specialist, you could look for a different office-based job in a medical facility. For instance, as a medical secretary, you would perform administrative tasks like scheduling patient appointments, filing patient transfer paperwork and processing health insurance payments. The minimum educational requirement is a high school diploma, but having a postsecondary certificate or diploma can boost job prospects. If you are more interested in a general human resources position, you could consider becoming a human resources manager, where you would be in charge of handling a variety of employee-related issues. For instance, you would hire new staff and facilitate communications between employers and employees. It is important to note that human resources managers need a bachelor's degree.

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