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Professionals who work in the medical and healthcare fields have to pass rigid requirements to gain entry into their fields and remain eligible to work. These requirements are often called credentials. Credentials for medical professionals can be required by states, professional organizations or national agencies.

It is the responsibility of the medical credentialing specialist to track the credentials of the medical professionals who work at hospitals, clinics, doctors’ office or other healthcare facilities. Credentialing specialists may be asked to confirm credentials for newly hired employees or to keep track of credentials for current employees. They report to a medical facility’s administration staff and work as a go-between for the administration and clinical workers.

The challenge in this profession is to stay on top of the many different certifications and licenses that are required by medical professionals such as nurses, medical technicians, physicians and pharmacy workers. If medical providers are not up to date with their licenses, the medical facility they work for could be in violation of state and local laws and could be penalized.

Medical Credentialing Specialist Training

Employers may not require credentialing specialists to have advanced education in the field, but candidates may pursue a certificate program or an associate’s degree program. Those who attain a higher level of education can have more career opportunities and command additional compensation. Prospective workers in the field may also combine experience and education to attain a satisfactory career level.

Most education in this field combines medical courses like physiology and anatomy, medical terminology, and medical management courses with general business courses.  To enter most higher education programs, students must have a high school diploma or equivalent.

Medical Credentialing Specialist Certification

Credentialing specialists should also seek their own certification. Certification can be attained through the National Association of Medical Staff Services (NAMSS). To attain certification and become a Certified Provider Credentialing Specialist (CPCS), one must achieve a level of experience in the field and pass the CPCS Exam. An employer may provide a compensation increase based upon successful completion of the program.

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