Provider Enrollment Specialist Certificate

Expand your skill set, prove your worth, and prime your career for advancement

Of the nearly 600 respondents to HCPro’s 2020 MSP Salary Survey, 25% work in departments that carry out both medical staff services and provider enrollment.
Don’t get left behind in the healthcare industry’s relentless march toward integration! Prove your mettle in a rapidly evolving facet of your profession by earning the Provider Enrollment Specialist Certificate (PESC).

Offered by DecisionHealth, HCPro’s sister brand, the PESC is the only certificate available for professionals with a hand in provider enrollment to showcase their mastery in a growing market and demonstrate their immeasurable value to their organization.

Provider en­rollment professionals earn the PESC after passing a 50-question assessment that tests their knowledge and understanding of the different enrollment forms, specific terms and definitions, compliance risks and penalties, and the Provider Enrollment, Chain, and Ownership System (PECOS).

Show leadership that you have what it takes to faciltate prompt provider enrollment and accelerate access to revenue. Earning the PESC will help you:

  • Validate your proficiency in the enrollment process
  • Keep your skills relevant, applicable, and competitive
  • Identify any knowledge gaps and create a training roadmap
  • Advance your career and potentially earn a higher salary
  • Affirm your commitment to lifelong learning and increase job skills confidence

Learn more:

Check out our other provider enrollment resources

HCPro and DecisionHealth teams are committed to connecting credentialing and provider enrollment professionals with the expert-developed resources they need most to excel in an ever-evolving industry. Our current (and growing) collection of provider enrollment solutions include the following resources. 

Converging competencies: A complimentary white paper series

As healthcare organizations continue to redraw and dismantle the department lines that once divided medical staff credentialing and provider enrollment, a growing contingent of MSPs are helming both functions and learning a brand-new process on the fly. CRC's complimentary white paper series arms forward-thinking professionals with the career trend data, expert strategy, and field-sourced tales and tools they need to expand their skill set and stay competitive in an industry on the move.

Check out the white papers at the links below:

Managed Care Credentialing: Compliance Strategies for Health Plans, CVOs and Delegated Entities 

Whether you work for a health plan or a hospital medical staff services department, this how-to guide answers all of your health plan credentialing and enrollment questions. Learn the regulatory and accreditation requirements related to managed care credentialing, including those from CMS, NCQA, and URAC. Author Amy M. Niehaus, CPMSM, CPCS, MBA, provides readers with the guidance to create a comprehensive and compliant credentialing program to support your health plan or to streamline your hospital’s provider enrollment process through delegation. MSPs in all healthcare environments can benefit from understanding credentialing in the managed care world to support their organizational goals of compliance, operational efficiency, cost savings, and practitioner satisfaction. 

Verify and Comply: Credentialing, Medical Staff, and Ambulatory Care Stan­dards, Eighth Edition

Celebrated by medical staff and credentialing professionals for over 15 years, Verify and Comply is back, bigger, and better than ever. Credential­ing and medical staff standards and regulations are covered in one easy-to-navigate side-by-side crosswalk, giving MSPs a single resource that answers all their accredita­tion questions. This expanded guide includes ambulatory care, acute care, and man­aged care standards for the most popular regulators and accreditors: CMS, The Joint Commission, NCQA, DNV, HFAP, and AAAHC. This book allows you to compare what each accreditor states about initial appointment, reappointment, and other medi­cal staff functions, and provides tips and best practices to help you meet the most challenging standards. Use this resource to study for the NAMSS certification exam and to keep up to date with regulators’ and accreditors’ credentialing and medical staff standards across the growing array of credentialing environments, including provider enrollment departments.

Overcoming Contemporary Credentialing Challenges: Practical Strategies for MSPs and Medical Staffs

From increasing healthcare delivery and payment models to rapid-fire advances in telemedicine, credentialing software, and other game-chang­ing technologies, today’s MSPs and medical staff leaders face continual evolution in their field. To meet the demands of an industry on the move, traditional credentialing approaches and medical staff makeups must evolve as well—a task that requires stra­tegic intervention and broad buy-in. Featuring innovative guidance from three authors with wide-ranging expertise, Overcoming Contemporary Credentialing Challenges pro­vides actionable takeaways for contending with the culprits behind 10 of today’s top practitioner vetting pitfalls, including provider enrollment and delegated credentialing. 

Related Content: 

Provider enrollment: A new competency for MSPs to master
Provider enrollment credentialing specialist job description
Credentialing for Managed Care: Compliant Processes for Health Plans and Delegated Entities