Hot Job: Medical Credentialing

By Glenda Byers Shaffer, M.Ed., Adjunct Faculty

CTU Healthcare degree - Medical CredentialingThose who aspire to work in the medical field tend to work toward more commonly known professions, such as a physician or nurse. Perhaps a great career you’ve never considered before is as a medical credentialist. Credentialists ensure that state laws and accrediting body requirements are developed and met for ongoing quality of care provided by physicians and other health professionals.

The credentialing professional is referred to as a manager of medical staff services, medical staff coordinator, credentialing specialist or director of credentialing. An entry-level professional’s title may be as a credentialing assistant or associate. Primary job functions for this field include:

  • Overseeing processing of credentialing of all physicians and health practitioners within their specialties.
  • Maintaining knowledge of standards of the Joint Commission on Accreditation of Healthcare Organizations, National Committee on Quality Assurance (NCQA), state and federal regulations, and legal cases related to medical staff organization.
  • Developing, establishing and enforcing medical staff bylaws, rules and regulations, and policies that govern the activities of medical staff.
  • Assisting a credentials committee with development of criteria and other documents necessary to provide an effective credentialing process.
  • Documenting the activities of a medical staff executive committee.
  • Ensuring computerized documentation is completed for all credentialed physicians and other health professionals.
  • Supervising staff that performs the above functions.

A job description for a medical credentialist might read like this:
Responsible for coordination and oversight of the medical staff services department, to include physician credentialing, managing meetings and providing for a flow of information from medical staff committees to the medical executive committee and governing board. Assist with Joint Commission (JCAHO) survey preparation. Work closely with medical staff leaders, hospital administration and legal counsel to ensure required items from the medical staff bylaws and policies are developed and followed.

What are the educational and other requirements you’ll need for this type of position? They include:

  • An associate or bachelor’s degree in healthcare management
  • Two certifications - Certified Professional Medical Services Management (CPMSM) and/or Certified Provider Credentialing Specialist (CPCS)
  • Affiliation with the National Association of Medical Staff Services (NAMSS)
  • Excellent interpersonal skills, including the ability to communicate professionally both verbally and in writing.

CTU Faculty - Glenda Byers ShafferWith more than 15 years of experience in health care and higher education, Glenda Shaffer, M.Ed. is an adjunct faculty member at CTU. She holds a bachelor’s in business administration and actively serves on CTU’s Health Administration Program Committee, a group that reviews and updates CTU courses.



Stay in the know. 
Subscribe to CTU’s blog and receive fresh updates directly to your inbox. Join us.


Image credit: Flickr/Funky64


Terms and Conditions By providing your mobile number, you agree to receive text messages from Colorado Tech via its mobile text message provider.  You may opt out of receiving messages by texting the word STOP to 94576, or simply reply with the word STOP to any text message you receive from Colorado Tech. While CEC or its mobile text message provider will not charge end users for receiving/responding to promotional messages, depending on the terms of your mobile phone plan, you may incur a cost from your mobile service carrier to receive and respond to any promotional text messages (standard messaging and data rates/fees and other charges may apply).  Charges will appear on your mobile phone bill or will be deducted from pre-paid amounts.  Current participating/supported carriers are: Alltel, AT&T, Boost, Cellcom, Cellular One, Cellular South, Cincinnati Bell, Cricket, Element Wireless, Golden State Cellular, iWireless, Metro PCS, Nextel, nTelos, Plateau Wireless, Sprint, T-Mobile, US Cellular, Verizon Wireless, Viaero Wireless, Virgin, and more.×