Accreditation specialists verify employee and vendor credentials in healthcare-related industries, ensuring compliance with regulatory standards. They create and maintain accreditation reports and require a bachelor’s or associate’s degree, industry experience, and basic computer skills. After 12 months, they can obtain the CPCS designation.
Accreditation specialists work in a wide variety of healthcare-related industries. They are usually responsible for verifying employee and vendor credentials. Many professionals in this role have multiple other responsibilities and experience in the physician’s office. Some jobs in this field require specific certifications and educational requirements.
A credentialing specialist may work for an insurance group or for a healthcare organization or organization, such as a hospital or outpatient care company. This person works to ensure that his employer and all parties or companies he works with comply with all regulatory standards. He or she verifies and processes all accreditation information through a rigorous verification process. This process may include calling insurance companies, universities, and certification boards, as well as verifying all information with government-regulated databases. This position also often works with internal and external auditors when your employer is going through its own accreditation process.
Other responsibilities for someone in this position include creating and maintaining important accreditation reports. These reports typically collect all information about credentialing, installation privileges, and membership in associations or other groups. When collecting the information, the specialist must compare it to government guidelines and apply the information when processing accreditation applications. An example of this is when a credentialing specialist working in a hospital verifies a physician’s education, certifications, and work history to grant admission privileges.
Most employers are looking for an accreditation specialist with a bachelor’s degree or at least a two-year associate’s degree. Along with educational requirements, most credentialing positions require applicants to have worked in a medical office or setting in some form. They should be familiar with industry standards and guidelines for documenting vendor and facility credentials. Other common requirements include basic computer skills and experience working in spreadsheet and word processing programs.
After an Accreditation Specialist has worked in the position for at least 12 months, he or she can work toward the Certified Provider Accreditation Specialist (CPCS) designation. This designation is required to be able to work as a medical credentialing specialist or in positions that manage the certification and licenses of staff members. Certification is obtained through groups such as the National Association Medical Staff Services, American Academy of Professional Coders, Medical Specialties Coding Council, and Professional Association of Health Coding Specialists.
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