Credentialing Specialist: Education and Job Training Requirements for Becoming a Credentialing Specialist

Published Nov 08, 2009

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Credentialing specialists are employed in the health field. They check the credentials of doctors and other healthcare practitioners for their employers, such as a hospital. While a minimal amount of schooling is technically required for credentialing specialists, earning certifications may help a credentialing specialist secure and keep a position.

Credentialing Specialist Career Summary

A credentialing specialist works in the health care industry, verifying doctors' or other types of practitioners' credentials, processing the information and keeping all information in data files at a health care facility, in an insurance group or another health care industry employer. Credentialing specialists prepare and maintain reports of employees based on accreditation, education, facility privileges, experience, membership and licensure, ensuring all employee information meets federal, state and local guidelines. They maintaining regular written and verbal correspondence with agencies, hospitals, malpractice carriers and medical review boards. In addition, credentialing specialists are required to maintain knowledge of current American Accreditation Healthcare Commission standards. Other duties may be assigned, so credentialing specialists should be prepared to think on their feet.

Education Required to Become a Credentialing Specialist

According to job listings on, credentialing specialists just starting out may get into this career with a high school diploma or equivalent. However, many employers now require a bachelor's degree in business or a related field. Within their studies, credentialing specialist students should gained the skills to organize, manage and control workflow to meet deadlines, to use a personal computer and to communication and interact with others effectively.

Job Training and Certifications Required to Become a Credentialing Specialist

According to job ads, credentialing specialists should be a certified professional in medical services management, a certified provider credentialing specialist or both. Each certification test requires the applicant to have been employed in the medical field for at least 12 months. A certified professional in medical services management will have an in-depth knowledge of medical staff bylaws, standards, management processes, hospital procedures and accreditation standards. A certified provider credentialing specialist may earn a greater salary than may those without certification. Certification shows employers the applicant is knowledgeable about credentialing and obtaining certification may increase job security. Both certification tests are available through the National Association Medical Staff Services.

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