Job Description

Job Title: Lead Credentialing Coordinator
Job ID: 688298
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility:
Department: POP00 Health Information Mngt
Location: 3600 Forbes Ave, Pittsburgh PA 15213

Description

Purpose:
The UPMC Credentialing team is looking for a Lead Credentialing Coordinator!  This role performs all aspects of credentialing and enrollment operations for the department and functions as a resource to the department managers and/or directors. The lead functions as the expert user for the software applications and assists with database integrity and maintenance. This role performs application processing, data entry and verification functions according to established policies, procedures and guidelines.

This role is located at the Forbes Tower and the schedule is Monday through Friday, 8:00am to 4:30pm.  Sound like a fit for you?  Apply today!

Responsibilities:
  • Assists with competency assessment of the staff annually and as necessary.
  • Assists with the development, implementation and revision of processes, policies and procedures to assure the effective and efficient operation of the department.
  • Assumes responsibility for the office e-mail and inquiries when requested.
  • Competent in the job responsibilities of all staff members and performs their job duties and responsibilities as necessary.
  • Develops data entry standards to maintain the integrity of the database and completes projects to assure the completeness and accuracy of the data.
  • Functions as the expert user for the software application and provides help and issue resolution for the staff, the users and the practitioners.
  • Manages the process for follow up for application and reapplication packets received incomplete.
  • Performs all aspects of credentialing and enrollment operations for the department and functions as a resource to the department/practice managers and/or directors.
  • Performs all the duties of the Credentialing Coordinator including application processing, data entry and verification functions according to established policies, procedures and guidelines and serves as a role model for the Coordinators.
  • Provides initial orientation and ongoing training in the use of the software and for application processing and verification.
  • Resolves day-to-day staff issues and interoffice conflicts as necessary and assures that productivity is not negatively impacted.
  • Works to resolve software related issues and to maximize the use of the technology and functionality.

Qualifications

  • Prior credentialing experience (two years required - three to five years preferred). 
  • High school diploma required (Bachelors Degree preferred).  
  • CPCS (Certified Provider Credentialing Specialist) certification preferred. 
  • Experience with both JCAHO and NCQA standards preferred.  
  • Excellent communication and organizational skills required.
  • Excellent computer software application skills required and must have a desire to maximize the use of technology to automate processes.

Licensure, Certifications, and Clearances:
  • Act 34 Criminal Clearance

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $17.11 to $28.43

Union Position: No

Apply Current Employee?

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