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Medical Credentialing Specialist: Job Description and Requirements

Learn about the education and preparation needed to become a medical credentialing specialist. Get a quick view of the requirements as well as details about job duties, salary, and career outlook to find out if this is the career for you.

Essential Information

A medical credentialing specialist ensures that a health care facility and its staff's credentials meet government and accrediting agency standards. An associate's degree, along with communication, organization, and administrative skills, can begin a career in medical credentialing. Although not required by all employers, professional certification may greatly increase job opportunities and wages.

Required EducationAssociate's degree
Other RequirementsProfessional certification may be required or preferred by some employers
Projected Job Growth* (2012-2022)22% for all medical records and health information technicians
Median Salary* (2014) $35,900 for all medical records and health information technicians

Source: *U.S. Bureau of Labor Statistics

Medical Credentialing Specialist Job Description

Medical credentialing specialists are typically employed by different types of health care organizations, such as hospitals, group practices, ambulatory care services, and credentialing agencies. A specialist's main focus is to verify that the credentials of health care professionals are in compliance with state and federal standards. This can involve verifying the legitimacy of practitioner information with universities, licensing agencies, and certification groups. Along with processing re-credentialing paperwork and maintaining a database of practitioners' training, education, licensing, and experience information, specialists also ensure that practitioners adhere to staff policies, department regulation, and government laws.

According to the U.S. Bureau of Labor Statistics (BLS), medical records and health information technicians, such as medical credentialing specialists, typically worked 40 hours per week and many had possible overtime opportunities. Credentialing specialists typically work in office settings and, unlike most health care occupations, don't work directly with patients.

Medical Credentialing Specialist Requirements

Medical credentialing specialist positions generally require an associate's degree in health care or business administration or two years of experience in a medical office. Other requirements generally include interpersonal and organizational skills, as well as knowledge of administrative tools like word processing and spreadsheet applications.

Earning the Certified Provider Credentialing Specialist (CPCS) designation may increase job opportunities for medical credentialing specialists. The National Association Medical Staff Services (NAMSS) offers a CPCS certification program for medical service professionals in good standing with at least 12 consecutive months of experience in the field. According to NAMSS, over 27% of crediting specialists earned an increase in wages after earning their certification.

Salary Information and Job Outlook

According to the BLS, the median annual salary earned by medical records and health information technicians, including medical credentialing specialists, was $35,900 in 2014. Those working in medical and surgical hospitals were reported by the BLS to have earned an average annual salary of $41,350 that same year, and individuals working in the pharmaceutical industry averaged $50,170 a year. The BLS predicts that employment of medical records and health information technicians will grow by 22% between 2012 and 2022. According to the BLS, this growth is a result of more complex medical technologies and approaches, as well as an increased concern of legal liability among healthcare facilities and practitioners.

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