How To Become a Credentialing Specialist

Do you like to be organized and detailed, and are you interested in the behind-the-scenes of hospitals and clinics? If yes, you can consider how to become a credentialing specialist to start a steady career in healthcare management. The physicians, nurses, and other providers are required to meet all the licensing, education, and regulatory requirements before they can practice, which are verified by a credentialing specialist. As the issue of physician shortage is on the rise, and telehealth is growing faster than ever, the need to find qualified medical personnel to certify professionals has never been higher.

According to the research, estimates are that healthcare and health information management will experience 15.2 percent job growth between 2023 and 2033, significantly more than the national rate of occupational growth. Ready to get started as a credentialing specialist? The following blog will take you through all that you need to know.

What is the Work of a Credentialing Specialist?

Know the daily reality first before you leap. Credentialing specialists (also known as provider enrollment specialists or medical staff credentialing coordinators) receive, check, and store important records, including:

• Medical licenses  
• DEA registrations  
• Board certifications  
• Malpractice insurance  
• History of education and training.  
• Reports of the NPDB (National Practitioner Data Bank)

They also handle expirables, apply to insurance companies and hospitals, chase after delays, and also comply with the Joint Commission, NCQA, and CMS requirements.

The majority of specialists are employed by hospitals and physician groups, managed care organizations, or third-party credentialing companies like Capline Healthcare Management.

Average salary? Salary.com estimates the national average of $46,123 per year, which breaks down to an hourly rate of $22. Here’s a table for better understanding:

 

Levels	Salary
Entry Level Credentialing Specialist	$45,506
Intermediate Level Credentialing Specialist	$45,938
Senior Level Credentialing Specialist	$46,864
Specialist Level Credentialing Specialist	$47,049
Expert Level Credentialing Specialist	$47,172

Why go for a Career in Medical Staff Credentialing?

• Job security because there is no end to the healthcare field.  
• Remote and hybrid opportunities are typical.  
• No patient-facing stress  
• Obvious career ladder (specialist – supervisor – director)  
• The direct effect of your care is on patient safety by ensuring that incompetent providers are locked out.  

How to Become a Credentialing Specialist? (Step-by-Step)

Step 1: Minimum Education Qualifications

The minimum degree required by most employers is an associate’s degree. The most popular majors are:

• Health Information Management.  
• Healthcare Administration  
• Business Administration  
• Nursing (RNs usually mature into credentialing)  

It can be a great advantage to a bachelor’s degree, particularly in large hospitals or for companies like Capline Healthcare Management, where credentialing is needed in large volumes.

Step 2: Relevant Experience (Even Entry Level)

Many people break in through:

• Medical billing or coding roles 
• Physician practice front or back office jobs 
• Health insurance customer service or provider relations 
• Hospital medical staff services coordinator assistant 

A resume stands out even after half a year of administrative healthcare experience.

Step 3: Learn to Use the Key Software and Tools

The best skills that you require to answer how to become a credentialing specialist in 2025 are:

Software/Tool	Used By % of Employers
MD-Staff / CredentialMyDoc	42%
Symplr / VerityStream	31%
Echo (HealthStream)	18%
CAQH ProView	95%+
Microsoft Excel (advanced)	89%

 

Begin practicing CAQH (Council for Affordable Quality Healthcare) now; it doesn’t cost much and is the most popular application that insurance companies use.

Step 4: Obtain a Credentialing Certification (Strongly Recommended)

Not a necessity, but certification will raise your salary and hireability by a significant percentage.

There are two gold-standard certifications:

Certification	Issuing Organization	Experience Required
Certified Provider Credentialing Specialist (CPCS)	NAMSS (National Association Medical Staff Services)	3 years in the last 5
Certified Professional Medical Services Management (CPMSM)	NAMSS (National Association Medical Staff Services)	5 years in the last 8

 

Many experts begin with the CPCS and obtain the CPMSM in leadership positions subsequently.

Other desirable (yet not so popular) certifications:

• RHIT (Registered Health Information Technician)  
• FACMPE (Member of the American College of Medical Practice Executives)  

Step 5: Have a Resume and LinkedIn Profile

Remember to have an outstanding resume and a LinkedIn profile. Always use action verbs in a resume and add figures. For example

•  Claims to verify 150+ primary sources monthly with 99.8% accuracy.  
•  Less average payer enrollment time from 124 days to 78 days.  

Include job description keywords: credentialing certification, credentialing specialist, medical staff credentialing, provider enrollment, CAQH, NCQA, primary source verification, etc.

Step 6: Apply Strategically

Hot job boards in 2025:

• NAMSS Career Center  
• Indeed & LinkedIn (Search “how to become a credentialing specialist”)  
• Health eCareers  
• Internal career sites in the hospital.  

Another great foot in the door is the contract-to-hire positions via the RCM and credentialing outsourcing firms.

What is the Time required to become a Credentialing Specialist?

When you think about how to become a credentialing specialist, one thing that comes up is the time it takes.  Let’s answer that:

• An associate degree + 1 year of administration experience, i.e., 12-18 months.  
• Beginning with zero, it takes 2 to 4 years (including education and building experience).  
• Accelerated 6-12-month medical staff services certificate programs are the new offerings of many community colleges that accelerate your success.

Frequently Asked Questions (FAQs)

Q: Will I be able to become a credentialing specialist with no experience in healthcare?

A: It’s difficult but possible. Begin as a credentialing assistant or enrollment coordinator in a large outsourcing company; many have to be trained on the job.

Q: Does the NAMSS certification pay?

A: Absolutely. CPCS/CPMSM job postings increased by a significant percentage in 2022-2025 and favored it. On average, certified specialists are paid much more.

Q: Do I need to know medical terminology?

A: Yes. Operative reports, residency certificates, and malpractice policies are all things you will read every day. Enroll in a medical terms course if you are new.

Q: Are remote credentialing jobs?

A: Yes, most of the jobs in 2025 will be able to work fully on a remote basis, particularly when using third-party firms.

Q: What is the difference between credentialing and enrollment of a provider?

A: Credentialing = hospital/facility privileges. Provider enrollment = contracting the doctor and getting him paid by insurance companies (Medicare, BCBS, United, etc.). Most specialists do both.

Q: How much math is involved?

A: Very little. Expirables tracking and reporting require good skills in Excel, but no sophisticated mathematics.

Conclusion

The medical sector will never be short of intelligent, reliable individuals to help in verifying the capabilities of the doctors. In case you love checklists, problem-solving, and knowing your job is protecting patients, being a credentialing specialist will provide you with the feeling of stability, a good salary, and actual impact without burnout in direct patient care.

The first step is to revise your LinkedIn headline and make it reflect your current status as an aspiring Certified Provider Credentialing Specialist (CPCS) in Healthcare Administration, create a free CAQH account, and take a course in medical terminology.

Want to gain experience within a short time or want to take the CPCS exam? The future of medical staff credentialing begins today. Get hired, get licensed, and see your career launch! 

If you need the credentialing services, then contact Capline Healthcare Management. We have helped hundreds of providers and practices with their credentialing needs.