credential specialist

How do you Become Healthcare Credential Specialist?

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The medical industry is one of the busiest and highly respected industries around the world. These medical professionals work hard and 24X7 to save and treat human lives. That is the reason these guys need experts to help them with the extra documenting work so that they can focus on saving lives. The extra work of these institutes includes; billing, credentialing, transcription, and medical history records.

All of these tasks can be outsourced to allow doctors, nurses, and staff members to focus on their in-hand work without worrying about the piles of paperwork. These services also allow clinics and medical organizations to save their money and time; which has increased the demand for such medical outsourcing services. It is a good and high paying industry to go into.

Let’s discuss how can you get started with medical credentialing services:

What is medical credentialing

A process of analyzing health service provider’s qualifications, including career history, education, training, residency and licenses, and any specialty certificates. It helps people to hire the right health service provider and therefore it is crucial for all medical institutes, organizations, and clinics to keep such informations up to date.

It is very important for each and every medical entity in the USA to keep updating their credentials throughout the year. The credentials must follow and match all standards and rules established by the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC).

What Does Medical Credential Specialist Do?

There are so many little details that a medical credential specialist needs to take care of. Their responsibilities include maintaining everything from doctors’ information to reviewing the licenses and keeping track of all of the information.

The major responsibilities of a credentials specialist are:

  • Maintaining databases for medical professionals and healthcare facilities
  • Processing paperwork relating to re-credentialing
  • Ensuring details such as the doctors’ and nurses’ education, training, licensing, experience and other information are up to date
  • Do a background check, contact the licensing boards, review license applications, request education details and interview references for verification
  • Assist the staff with hirings by reviewing the complete credentials of candidates

How to Become a Healthcare Credential Specialist

Following are the steps to become a healthcare credential specialist:

Step 1: Get a degree and the certificate for medical credentialing

Although you don’t need a specific degree to apply for the medical credentialing specialist certificate. However, many employers prefer candidates with a degree or experience in some kind of medical program.

Step 2: Gain Experience

Like any other field the more years you spend in medical credentialing tasks the more expert you become. People prefer experience, knowledge of the medical industry, and knowledge of NCQA and TJC.

Step 3: Get the Certified Provider Credentialing Specialist (CPCS) Certificate

To apply for the CPCS one must either possess the certificate of Professional in Medical Services Management (CPMSM) or have 1-year working experience in medical services. More details of these certificates can be found