Credential Verification Specialist  What They Do

Insider Info

dotCredential verification specialists make sure that all clinical employees have the necessary training and certifications before they are hired. After someone is hired, these specialists ensure that all staff keep current with their certification.

They collect and maintain credential data for all clinical employees whose jobs require certification.

They check on the experience, training and references for all doctors, nurses and other clinical staff. For example, a doctor needs a registration for prescribing medicine. He also needs board certification, a license and of course a medical degree.

dotThese specialists can work in the administration departments of hospitals or medical centers. They can also work on a contract basis.

In the private sector, credentialing services work on contract for hospitals or health-care organizations. They obtain the necessary records and notify clients when credentials need updating. These companies are called credential verification organizations, or CVOs.

dotGood communication skills are necessary. You have to get the proper documents from the medical personnel or credentialing agencies.

"A person should have excellent communication skills and be very tactful and diplomatic when dealing with issues concerning physician licensing," says Mark Sumner. He is the credentials coordinator for a hospital.

dotThese specialists answer questions from clinical staff and department heads. In some cases, they deal with patients needing reassurance on the qualifications of their doctor.

You need the ability to handle many tasks at a time to work in this field. You must remain organized, work with limited supervision and know how to minimize interruptions.

dotThe work is repetitive. But some say it can take on the feel of detective work.

"I found it to involve a lot of digging at times," says Cindy Carrol. She is a former credentials manager in Naples, Florida.

"But if you know the right department to call at the CVO or medical center, and ask the right questions, you can easily find the documents you need to help someone have all her papers in order to be hired."

"Do not turn credentialing into routine verification assembly line work," cautions Sumner. "Keep each case separate and you'll find it's quite interesting and very rewarding."

dotCertification records in hospitals, nursing homes, and other health-care facilities need to be updated. Credential verification specialists update records as certifications come up for renewal.

They may contact the physician or medical personnel for proper documentation. Or they may work with a credentialing organization to help keep records current.

If certification records are missing or expired, the specialist will notify the medical personnel that their records will be placed on hold until required records are obtained.

At a Glance

Make sure employees stay current with certifications

  • Good communication skills are necessary
  • Many of these specialists work in the administration departments of hospitals
  • It's wise to get a degree in personnel management, health administration or law