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Credentialing Specialist Job Description

by Luanne Kelchner

There are plenty of jobs in the health-care field for people who prefer not to work with patients. The U.S. Bureau of Labor Statistics predicts a 33 percent growth in employment in the health-care and social assistance industries between 2010 and 2020. An increase in the number of health-care jobs may offer employment opportunities for credentialing specialists.

Responsibilities

Credentialing specialists work in health-care facilities verifying the credentials of medical staff. The credentialing specialist ensures that the hospital or health-care facility complies with federal and state regulations regarding licensure and certification of medical professionals. The specialist acts as a liaison between hospital administration and the medical staff, including physicians, technicians and nurses. Credentialing specialists maintain the data for all providers in the facility and track the expiration of certifications and licenses. These specialists also ensure that health-care providers update their certification or licensing on time. The specialists also process new applications for physician privileges to the facility.

Education and Training

Associate degree and certificate programs are available that train aspiring credentialing specialists for a career in the field. Courses in an associate degree program may include computer training, health professions management, anatomy and physiology, medical terminology, medical staff law and principles of management. While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree. Employers may also require applicants to have some experience in the medical services field to qualify for a position.

Certification

Employers may require applicants to obtain certification to qualify for a position in a health-care facility. The National Association Medical Staff Services offers the Certified Provider Credentialing Specialist certification. Candidates for the credential must have at least three years of experience within the last five years in a medical services profession. Applicants with the Certified Professional Medical Services Management credential can qualify for the certification with one year of experience in the field. Applicants must also pass a credentialing examination. The certification examination tests the candidate’s knowledge of credentialing operations, regulatory compliance requirements and the credentialing and privileging process.

Skills

Credentialing specialists must have strong organizational skills to monitor and track the credentials of the medical staff in a health-care facility. The position also requires good written communication skills to create letters and e-mails to providers and administrators in the organization. Credentialing specialists must be able to work independently, analyze data and conduct research while performing the duties of the job.

About the Author

Luanne Kelchner works out of Daytona Beach, Florida and has been freelance writing full time since 2008. Her ghostwriting work has covered a variety of topics but mainly focuses on health and home improvement articles. Kelchner has a degree from Southern New Hampshire University in English language and literature.