The Certified Provider Credentialing Specialist (CPCS) is typically employed or contracted by a healthcare organization including, but not limited to, hospitals (health systems), health plans, ambulatory care settings, group practices, and credentialing verification organizations.
A CPCS is an integral part of a credentialing team whose responsibilities include but are not limited to:
- Maintaining compliance with regulatory and accrediting bodies;
- Participating in the development and implementation of credentialing processes and procedures;
- Credentialing of physicians, allied health and other practitioners;
- Overseeing or participating in the development of and adherence to:
- Governance bylaws;
- Department rules and regulations;
- Policies pertaining to medical staff, practitioner/provider, and the organization; and
- Collecting and maintaining an accurate practitioner database and analyzing verification information.
Why Earn Your CPCS Certification?
Certification by NAMSS puts you in the driver’s seat: It increases your potential for advancement in any healthcare environment and indicates to your supervisor(s) and accreditation surveyors that you are an expert in the field, both of which enhance your value and job security. Here are some other reasons for credentialing specialists to seek certification by NAMSS:
- More than 27% of current certificants received a salary increase as a result of their certification by NAMSS.
- By achieving your CPCS designation, you gain confidence and demonstrate professional competence in the application of your knowledge.
- CPCS certificants cite recognition and respect from peers and supervisors as a top value of certification.
CPCS Examination Eligibility Requirements
At the time of application, the candidate must be employed in the medical services profession for at least 12 consecutive months in the last 24 months AND have a total of three years of experience in the medical services profession within the past five years.
This examination is designed to test knowledge on the broad scope of those professionals employed at the level to which the title “Credentialing Specialist” would appropriately apply. While those activities in the field of provider enrollment are a respected function in the healthcare industry, the CPCS exam does not include content relative to provider enrollment. The CPCS exam tests specifically in the areas of credentialing, privileging, and primary source verification.
Hands-on experience with the application of accreditation standards and experience with conducting the credentialing activities is a requisite for the candidate for certification. Provider enrollment specialists are typically involved in the facilitation of applications and information but are not involved in hands-on credentialing. Moreover, candidates are expected to have current, direct, preferably hands-on involvement in the major processes typically associated with this aspect of the health care industry including a majority of the areas covered in the Exam Content Outline in the Candidate Handbook.
CPCS Practice Test
CPCS Exam Content Outline
NCCA Accreditation: NAMSS certifications are the only NCCA accredited certifications for the medical services profession. By holding an accredited certification, you are demonstrating to your employer, the MSP community, and to yourself that you have the skills and knowledge required to complete your job as defined by the leading authority in the credentialing industry.