Full employer posting
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
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.
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: Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran
About the role
Maintain accurate provider credentialing and recredentialing records, ensuring compliance with organizational, state, federal, and NCQA standards.