Credentialing Specialist

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