Becoming a Credentialing Specialist
Certified professional credentialing specialists (CPCS) usually work in a healthcare organization, such as a hospital, ambulatory care clinic, group practice, insurance company or a credentials verification organization. Duties generally include assisting with the credentialing and re-credentialing process, making sure practitioners submit accurate and timely credentialing applications, maintaining the organization's credentialing database, reviewing any disciplinary reports or sanctions and participating in the credential verification process.
So what are the career requirements? There is no degree required for this position, but some employers may prefer candidates with an associate's degree or higher. The degree field should be healthcare or a related field. CPCS certification is optional but preferred by many employers. Most employers look for someone with 3+ years of related experience. The key skills you should have include excellent written and verbal communications, attention to detail, analytical skills and the ability to prioritize work and manage deadlines. According to Payscale.com, the median salary for a certified professional credentialing specialist is $43,117.
Step 1: Consider Earning a Degree
While having a high school diploma or GED is the minimum requirement for being a CPCS, many employers prefer hiring candidates with at least an associate's degree in healthcare or business. A 2-year degree is typically sufficient for this position; however, a 4-year degree can provide more support to an individual in a competitive job market.
Degree programs in healthcare-related fields generally combine courses such as medical terminology, ethics, administration and coding with liberal arts courses, such as English, behavioral sciences and math. Business degree programs offer courses designed to prepare students for preparing and presenting reports. Coursework commonly includes accounting, economics, business communications and ethics.
Step: 2: Obtain an Entry-Level Job in Medical Services
To be eligible for the CPCS exam, candidates either hold a certified professional in medical services management (CPMSM) credential and have current working experience in medical services for at least one year, or have a total of three years of medical services experience in the past five years, with at least one year of current experience. Gaining an entry-level job in healthcare is an ideal way to fulfill this requirement while gaining hands-on experience in a medical environment.
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Step 3: Prepare for the Certification Test
NAMSS offers a preparation course and an online prep course to help individuals prepare for the certification test. Aspiring CPCS candidates should be familiar with the privileging approval and application process, source verification, the credentialing application process, re-credentialing policies and the regulations that apply to all medical environments.
- Take the CPCS practice exam. Taking the practice test helps familiarize candidates with the type of questions asked on the test. The practice test has 40 multiple-choice questions.
Step 4: Take the Certification Test
The test application can be accessed on the NAMSS website. After completing the application, individuals should mail it, along with the specified testing fee, to the NAMSS. After the application is approved, candidates receive a Notice to Schedule (NTS) by email. Candidates can schedule exam appointments online by choosing from available exam locations and appointment times.
CPCS candidates are allowed three hours to complete the 150 multiple-choice questions on the exam. Before starting the exam, candidates are allowed 15 minutes to complete a short tutorial to allow certification candidates to become familiar with the software. To pass the CPCS exam, individuals must receive a score of 400 or better.
Step 5: Maintain Certification
To maintain certification, the CPCS must re-certify with NAMSS every three years. Eligibility for re-certification includes submitting the re-certification fee and completing 30 credits of continuing education. Individuals who fail to re-certify on time must submit a new certification application and retake the exam to renew the certification.
- Maintain records of continuing education activities for 2 years after completing certification renewal. Although individuals don't have to submit documentation of continuing education during re-certification, having the documentation on hand is important in case of an audit.
Step 6: Pursue Career Advancement
Experienced credentialing specialists may be eligible for promotion to positions with more responsibility, depending on the organization. In some cases, pursuing an advanced degree in a relevant field can increase opportunities for career advancement.
Consider a degree, gain work experience, obtain and maintain certification and pursue career advancement are the steps to make the most out of a career as a certified professional credentialing specialist.