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Credentialing Analyst - UPMC Washington, Medical Staff Office

UPMC
Washington, PA Full Time
POSTED ON 3/8/2025
AVAILABLE BEFORE 5/7/2025

Join Our Team as a Credentialing Analyst! Are you detail-oriented and passionate about ensuring healthcare excellence? Our hospital is seeking a dedicated Credentialing Analyst to join our team. In this role, you will play a crucial part in maintaining the highest standards of patient care by verifying and managing the credentials of our medical staff.

Responsibilities:

  • Provide support to Data Management including but not limited to: spreadsheet maintenance, license, degree and insurance product data query in contract and credentialing
  • Demonstrate knowledge of state, federal, and NCQA regulations concerning credentialing.
  • Complete provider complaint documentation.
  • Assist to identify provider files requiring urgent attention.
  • Utilize NPDB and the federal cumulative sanction software for credentialing.
  • Maintain complete and accurate records regarding credentialing/re-credentialing for practitioners or facilities as assigned.
  • Initiate consultation with the Chief Medical Officer or designee when provider specific information warrants, to include but not limited to NPDB queries, claims histories, licensure, references.
  • Maintain confidentiality concerning queries through all credentialing processes.
  • Track expired data for providers and follow-up appropriately including state licensure, professional references, NPDB, etc.
  • Complete PsychConsult Network Credentialing Manager checklist for all practitioners assigned for review.

Schedule: Monday-Friday, 8M-4PM but this is flexible depending on what the selected candidate may need.

Salary : $23 - $29

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