Purpose:
Join a team that plays a vital role in delivering safe, high-quality patient care. As a Credentialing Analyst, you'll collaborate with physicians, advanced practice providers, and hospital leadership to ensure providers are properly credentialed and compliant, making a direct impact on the hospital's ability to serve its community
Responsibilities:
- Maintain accurate provider credentialing and recredentialing records, ensuring compliance with organizational, state, federal, and NCQA standards.
- Verify and track provider credentials, licenses, insurance information, sanctions, and other required documentation.
- Perform primary source verification using databases and tools such as NPDB, Equifax, and federal sanction monitoring systems.
- Enter and maintain provider data in credentialing systems with a minimum 95% accuracy rate.
- Monitor expiring credentials and proactively follow up on licensure, references, sanctions, and other required renewals.
- Communicate directly with providers, medical staff, and internal departments to facilitate timely credentialing and issue resolution.
- Review, document, and escalate provider-specific concerns, complaints, and credentialing risks to appropriate leadership when necessary.
- Prioritize and manage credentialing workloads to ensure timely completion of applications, reappointments, and compliance requirements.
- Coordinate site visits, credentialing reviews, and checklist completion while maintaining strict confidentiality throughout the process.
- Provide cross-functional support to the Credentialing team, including backup coverage, spreadsheet maintenance, reporting, and collaboration with contracting and network management teams.
Schedule: This position will work Monday-Friday, 7:30AM-4PM
- High school diploma or equivalent required.
- Experience in credentialing preferred
- Excellent written/verbal communication skills.
- Ability to gather and manipulate data accurately and consistently.
- Strong organizational skills.
- Ability to manage multiple task and be flexible to the daily needs of the organization.
- Computer competence.
- Attention to detail.
Licensure, Certifications, and Clearances:
UPMC is an Equal Opportunity Employer/Disability/Veteran