Leadership

MSPs, What’s Our Worth?

By Christinia Cannady, CPMSM, CPCS, PESC

“How do you measure your worth in the credentialing world?” During my tenure as an MSP, this question has arisen several times, and I am sure you have experienced it as well. Is it measured by your education, years of experience, skillset, certification, or a combination of them all? If that is how you measure your own worth, how does your employer measure your worth? Does your assessment of your value align with your employer’s?

I have had to face some tough truths that credentialing, although a necessary field with essential tasks, has been and remains to be undervalued by several stakeholders. It may be a lack of knowledge of the importance of processes or of the background of fellow MSPs. I believe most individuals who are not in the credentialing world find it confusing to understand the demands of our roles, the several hats we wear throughout our day-to-day work, and our overall career. In my opinion, there are three main areas where MSPs find themselves employed within their careers: credentialing, payer enrollment, and medical services.

In the credentialing classification, the MSP would complete internal credentialing processes to satisfy accrediting bodies such as Accreditation Association for Ambulatory Health Care (AAAHC), American Association for Accreditation of Ambulatory Surgery Facilities (Quad A), or The Joint Commission (TJC). These MSPs typically work in the hospital or Credentials Verification Organization (CVO) settings. Their duties are to undergo the application process with providers to obtain privileges with their organization/hospital. As part of this process, they complete primary source verifications of their credentials to create a complete credentialing file to be reviewed to determine if they are fit to provide services to patients. Based on criteria of medical staff bylaws and the accrediting body standards, the file is then approved or denied. Additional processes include ongoing monitoring and recredentialing of active providers, which generally takes place every two or three years to ensure they remain in compliance.

A possible MSP role in payer enrollment is verifying provider credentials in efforts to add them to payer plans and networks. If employed by a health insurance company, the processes will be similar to those listed above for credentialing. However, if you work for a medical practice/organization, the MSP’s responsibility is to review payer requirements for participation and submit applications to join their network. The accrediting bodies that payers abide by include but are not limited to the National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), and Centers for Medicare & Medicaid Services (CMS). There are two types of payer enrollment credentialing: delegated and full credentialing processes. Other areas include processing of quarterly attestations, revalidations, and provider data management updates which have mostly moved to online portals and payer directories.

The area I classify as medical services is where the MSP assists providers with upkeep of their licensure, certifications, and hospital memberships. This includes assistance with hospital privilege applications, expirable management, initial and renewals of state license, Controlled Dangerous Substance Registrations (CDS), and Drug Enforcement Agency Registrations (DEAs). They are responsible for updating, collecting, and storing providers’ credentials and data within the internal credentialing system/file. Some of these positions are held within organizations and hospitals, but on the other side of the spectrum, could be held at a state medical board or office of registration.

MSPs play a vital role in quality assurance, patient safety, and overall growth of a provider’s practice, organization, or hospital. All previously mentioned areas of credentialing are imperative in the continuous processes and ongoing monitoring of providers to be deemed compliant to provide services to patients or members. There are many steps involved in each of these processes, and they should not be overlooked. The credentialing process allows MSPs to catch “red flags” such as sanctions, violations, malpractice claims, etc. Once gathered, they provide risk assessment data to operations, leadership, or their governing body to make informed decisions regarding to whom they choose to grant medical staff membership or participation. There have been numerous instances showcased over the years in which providers were approved for medical staff membership to treat patients even though they lacked the necessary knowledge, training, or credentials. To minimize the risk of such occurrences, workflows, processes, medical staff bylaws, policies, and procedures should be reviewed and updated annually or as needed to validate efficiencies.

MSPs should be well trained and have specific skills to enhance the organization’s compliance rate. Within our credentialing profession, the tedious tasks we encounter on a day-to-day basis require that we are held to a certain standard when it comes to our skillset. Some of these skills include flexibility, efficiency, ability to take constructive criticism, and the ability to follow processes. MSPs must be detail oriented, have good interpersonal skills, be organized, be able to work independently, and to collaborate as a part of a team. We are researchers or “detectives” who find solutions to problems. All these skills and qualifications should be considered in MSPs’ worth evaluation.

Through researching, I have discovered the following information, just to list a few of the roles and their average salaries in the United States:

• An MSP in the role of a credentialing specialist with 1-2 years of experience and a bachelor’s degree who reports to a supervisor would average a salary of $48,337 a year.
• An MSP in the role of a senior credentialing specialist with 5-6 years of experience and a bachelor’s degree who reports to a supervisor would average a salary of $59,855 a year.
• An MSP in the role of a credentialing supervisor can have a salary range between $68,117–$86,813 a year based on education, certifications, years of experiences, and number of direct reports, with an average salary of $76,725 a year. 
• A credentialing manager’s salary could range between $93,631–$118,287, with an average salary of $105,007 a year.
• On average, a credentialing director can make $163,039 a year. The range, based on the MSPs credentials and experience, is $140,617–$177,570.

The data above is based on the main criteria used when evaluating a professional’s credentials, including education and years of experience. However, it is also important to consider the locality of the position and professional certifications. There is starting to be a trend where organizations are leaning more toward hiring MSPs with certifications, as it speaks to their expertise and validation of dedication to the field. It would be beneficial for employers to educate themselves on the different levels of certifications offered to MSPs and what they entail to help form employee expectations. It will also assist in gauging knowledge standards and needs of the organization/department while recruiting prospective employees. As the practice grows, consider your ratio of MSPs to provider count to ensure the quality of credentialing remains consistent. If you are a supervisor, manager, or director overseeing credentialing staff, salary.com is a good tool to start your research on salary scales. It was utilized to pull the data listed above.

To ensure prolonged retention rates of MSPs with organizations, employers should be supportive of one's professional development. Forms of support can be provided with NAMSS membership, NAMSS certification, training courses, webinars, and NAMSS annual conferences. Some employers do  reimburse MSPs for these resources’ fees to ensure the MSP stays apprised of any changes in the credentialing world, which benefits the employer as well. Employers who invest in their employee’s professional growth and take the time to properly evaluate their worth can experience benefits such as a positive work environment, good employee morale, loyalty, higher productivity, longer retention rates, and a strong reputation for prospective new recruits as staff members.

What happens as a result of not being valued? Possible consequences of undervaluing an MSP include low morale, lack of motivation, and resignation from positions to seek other opportunities. Despite positive relationships that may have been formed at the most recent position, the hope is when one leaves an organization, hospital, or insurance company, they will find what they are looking for in another location. Many professionals search to find a position that will provide higher compensation, better benefits, employee recognition, positive work environment, title upgrade, continuous education/training, and growth opportunities.

As an MSP, regardless of what your current career level is, do your due diligence, know your worth, and do not be afraid to ask for what you believe you deserve, as long as you can back up your request. Also, know what steps need to be taken to position yourself in a manner to reach your goals.

Ways to enhance your value for your career include:

• Completion of a degree in healthcare management, business administration, or contracting/credentialing
• NAMSS membership
• NAMSS Certified Provider Credentialing Specialist Certification (CPCS®)
• NAMSS Certified Medical Services Management Certification (CPMSM®)
• Professional Enrollment Specialist (PESC)
• NAMSS Fellow Medical Services Professional (FMSP)
• NAMSS Leadership Certificate Program
• State Medical Services Membership

NAMSS continues to expand its range in credentialing matters so that there is knowledge to gain in every area. Some tools that can assist you in your journey include

• NAMSS candidate handbook
• NAMSS MSP career assessment
• Defining Tomorrow’s MSP®: The Future of the Medical Services Profession Report
• Volunteering for involvement with NAMSS or State Medical Services Membership
• Live seminars and recorded webinars

In closing, let’s try our best to be patient and educate others on our worth as MSPs. Communicate needs for growth, development, and access to necessary information to provide the support our employers require for best practices. Continue to advocate for one another and the credentialing profession. Always remember that we do what we do for the best interests of patients and members to ensure they get high quality care.

Visit the NAMSS Education Zone for certification information and prep courses, webinars, and more.