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Can't Find Experienced Credentialers?

Coaching and mentoring credentialers

Need help finding experienced credentialers? It does appear to be a shortage. But, first of all, has anyone ever heard of this career before being introduced to a healthcare organization? I hadn't heard of it when I was handed my first provider application to process. I was in the right place at the right time. The position was empty, and the Vice President of Medical Affairs turned to me, his temporary administrative assistant. I had been hired to greet people entering the C-Suite and to answer phones. But, this small hospital system needed someone to perform the function of credentialing—silly me. I had no clue, but I found out quickly.

Like me, only a few people had ever heard of a medical services professional who would be responsible for processing applications, whether in a hospital, a group practice, or a health plan. Let alone enrolling one in a health plan or Medicaid or Medicare. This role was a totally foreign concept. It wasn't in any of my college courses. It wasn't anything anyone I knew did for a living. This responsibility was a strange administrative profession that didn't exist to me before that moment.

I soon found out a few things about that job. It wasn't difficult. It wasn't tough. But, it required a lot of attention to details that could prove dangerous to a patient's health if missed. Everyone introduced to this profession soon finds out that they are a crucial part of the front-line protection, ensuring that the healthcare professionals in any healthcare setting are qualified, competent, and confirmed that they could deliver appropriate and safe care to anyone trusting that healthcare organization. So how do you find people to perform that function?

Ideally, you hire someone with experience or, at least, someone with exposure to the job. That's a start. You post the position in all the right places and hope you attract the right person. Or, you shop around in your organization to see if anyone is interested who has the eye for detail, the person who is reliable, and can get the job done. Do you know the one? That person who will see every file through to the conclusion wholly and quickly. Whatever their current position, you can always count on them to perform and satisfy the organization's needs. Or, you adapt your budget and outsource the roles to either a CVO or a staffing agency. Are you exhausted thinking about it yet?

And then, there is training. Training is always a great solution whether you take the time to mold someone with a suitable skill set or even those already in the positions. And I am not talking about training that includes step-by-step what they should do to close a file; I am referring to training them on the whys, the basis of what they must do. Teach your staff the hows, whys, and best practices. Yes, job aides, operations manuals, and policies are essential, but it's always best to give them the tools to assist with the critical thinking required in the day-to-day processes. Have you considered that?

Whether you need staff to onboard or monitor through reappointments or even enroll those providers, you need staff who knows and is invested in the whole picture. Some individuals will look at it as a job with a paycheck at the end of the week or month. But, you want to groom future medical services professionals who want to grow beyond being a credentialer. You want to help them prepare for a career that provides growth. So avoid looking to hire or train them in a dead-end job. There are so many avenues this position can take them down. Let them know. This one position, this one path, can not only lead to other opportunities related to credentialing. No one says they can't move into medical services management, quality, risk, utilization management, provider data, or network management. The basis of the medical services professional's role can lead upward. Look for someone who wants to expand, become professionally certified, and train, train, train.

Contact us if you need a mentor or a coach to help them see the possibilities.

Dilsa S. Bailey, CPMSM is the owner and principal consultant for The Right Credentials Network and an independent publisher and author. If your credentialing and provider enrollment programs need assistance, contact The Right Credentials Network. We can help you apply for and maintain accreditation, build your delegation arrangements and repair your existing credentialing program. And, if you or your staff needs additional training, let us create a package to fit your needs.


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