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How to Become a Certified Provider Credentialing Specialist (CPCS)

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.

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Do I Want to Be a Certified Provider Credentialing Specialist?

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 relied heavily on communication and organization skills and hours may be spent sitting in front of a computer.

Job Requirements

Most credentialing specialists have at least a high school degree or equivalent and become certified through National Association Medical Staff Services (NAMSS). The following table contains the most common requirements for becoming a CPCS.

Common Requirements
Degree Level Associate's degree preferred but not required*
Degree Field Medical staff services**
Certification Certified Provider Credentialing Specialist credential from the NAMSS***
Experience 1 to 3 years*
Key Skills Excellent written and verbal skills, high integrity because of the confidential nature of the work, organizational skills*
Computer Skills Experience with Windows-based software*

Sources: *Job ads from multiple employers (Dec. 2012), postsecondary programs**, National Association Medical Staff Services***

Step 1: Complete Postsecondary Education

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.

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.

Step 3: Get Certified

Credential specialists can get certified through the 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.

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