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The Anatomy of a Credentialing Specialist

A robust credentialing team can make or break a hospital or system. The right people will routinely evaluate, fine-tune, and optimize your processes, then execute them promptly and efficiently.

    What do you look for in a credentialing specialist? The right person will likely occupy three roles. 

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    Role #1–Connector

    At its core, credentialing requires connecting new providers with no context to a system with established protocols. New providers may feel like a fish out of water. As you dive into the verification process, you can connect new providers to all the departments they will eventually work with–IT, HR, medical staff, medical coding, and more. The more soft skills you can employ, the more pleasant the integration process will be. Look for a candidate that brings people skills to the table. 

    Role #2–Subject matter expert

    The verification process differs from hospital to hospital, so your team must be knowledgeable in every aspect of your process at the facility, accrediting board, and state levels. You cannot assume that new providers will know what’s needed or how to deliver it. Although your process may differ, asking new candidates about their experience is essential. Weave questions that require technical expertise into your interview process to test real-world skills. 

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    Role #3–Leader and innovator

    Even the most entry-level credentialing pro needs to keep their eyes open for ways to streamline the process and have the confidence to present innovative ideas to leaders in their facility. Candidates with leadership potential should demonstrate active listening skills, critical thinking, and a willingness to work with a team to better the process. 

    If your team is ready to expand, these qualities can help pinpoint the best candidates. Need more time to recruit? Look for these qualities in your existing staff. Cultivating leadership starts with listening to your staff and finding ways to grow.

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