How to Become a Certified Provider Credentialing Specialist (CPCS)

Feb 27, 2019

Learn how to become a certified provider credentialing specialist (CPCS). Research the career requirements, certification information, and experience required for starting a career in credentialing. View article »

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Should I Become a CPCS?

Certified provider credentialing specialists (CPCS) are responsible for maintaining regulations in healthcare settings, credentialing physicians and other healthcare providers, and maintaining a database and reports of verification information. Job duties include the review of applications and verification letters and the maintenance of pertinent databases for providers' information.

Credentialing specialists work in office settings, sometimes within larger medical care service communities, such as hospitals. Certified specialists usually work full-time positions during regular business hours. Few physical demands are expected of such professionals, and they are exposed to few risks of injury or illness. The job relies heavily on communication and organization skills, and hours may be spent sitting in front of a computer.

Career Requirements

Certified provider credentialing specialists generally have an associate's degree in medical staff services or similar fields and certification. Certified provider credentialing specialists have excellent written and verbal skills; high integrity, which is essential because of the confidential nature of the work; organizational skills; and experience with Windows-based software.

According to PayScale.com, the median salary of credentialing specialists with certification is $43,117.

Steps to Become a CPCS

Take these three steps to become a certified provider credentialing specialist.

Step 1: Complete Your Associate's Degree

While it's not a requirement for all jobs, many employers prefer candidates with an associate's degree. Degree programs in medical staff services usually take 2 years to complete and help prepare potential candidates to verify the credentials of healthcare providers and monitor adherence to healthcare laws. Coursework typically includes anatomy and physiology, medical law, terminology, management, and medical staff services. Some schools offer a co-op program that allows students to work with an employer to gain professional experience. Some employers may also prefer a bachelor's degree. Most schools require students to have a high school diploma or GED to enroll.

Success Tip #1:

  • You'll want to become proficient with relevant technology. As credentialing specialists often find themselves working with computers, it is a good idea to become familiar with office and business programs, such as Excel and Microsoft Word.

Step 2: Gain Work Experience

Many credentialing specialist positions require candidates to have 1 to 3 years of experience as a credentialing specialist or medical staff services provider, but the time spent working toward a degree combined with a co-op program can count toward experience. Candidates can gain experience in the field by taking an entry-level position in medical staff services and performing clerical or management duties in the healthcare field.

Success Tip #2:

  • You will want to become familiar with the auditing process. Credentialing specialists routinely assist auditors. To make this step go more smoothly, it is in the best interest of the credentialist to study the steps of an audit in advance so as to be prepared.

Step 3: Get Certified

Credentialing specialists can get certified through the National Association Medical Staff Services (NAMSS) if they have at least 3 years of experience in the medical services profession and have been employed for the past consecutive 12 months in a medical services position. Applicants must pass the CPCS exam to become certified. Re-certification is required every three years, and continuing education may be necessary. Certification shows that credentialing specialists have a good understanding of the field, and it can help them advance their careers.

Certified provider credentialing specialists usually have an associate's degree and certification. They handle confidential information carefully, and they earn a median annual salary of $43,117.

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