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Lead Credentialing Analyst EAP

  • Job ID: 021721067
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: National Service Center
  • Location: Work From Home
  • Union Position: No
  • Salary Range: $19.41 to $32.25 / hour

Description

UPMC Workpartners is seeking a full-time Lead Credentialing Analyst to join a superstar, close-knit, team of 14. 


The Lead Credentialing Analyst is responsible for actively recruiting and coordinating the timely contracting activities that are necessary to support the credentialing and recredentialing of LifeSolutions EAP contracted providers. This person will also provide provider-related support to the LifeSolutions National Service Center staff.

This position is daylight and work-from-home with travel into the office (US Steel Tower) as needed for meetings. 

Responsibilities:

 

  • Actively recruit providers in areas of need across the United States.Prepare and send contracting packets in a timely manner.
  • Monitor contracting packets and make outreaches to encourage the completion of the application process.Review incoming contracting packets for completion and obtain missing information.
  • Enter new provider information into electronic data system.Save all contracting documents in the correct online file systems.
  • Invite new providers to join the online portal to receive new referrals and submit claims.Act as coach and technical support for those having trouble with online portal submission.
  • Monitor online portal and enter tickets to resolve issues with application owner.Secure one-time agreements in a time sensitive manner.
  • Manage and monitor provider vacation/not taking new referrals calendar.Send monthly requests for updated licensure and/or liability insurance information.
  • Maintain oversite of the provider listing and make professional decisions leading to a larger and more diverse provider panel.Maintain and update all provider communication materials and forms as needed.

 

Qualifications

  • Associate degree in business or healthcare required
    • (Experience in business, healthcare or customer service may be substituted for educational requirements);
  • Five years of experience in credentialing required.
  • Experience in NCQA compliance in credentialing required.
  • Computer efficiency in database entry, Excel, word processing and report generating essential
  • .Five years of data entry or related experience preferred.
  • Excellent written and verbal communication skills required.
  • High degree of organizational skills with excellent problem-solving skills required.
  • Demonstrated performance in meeting deadlines required.
  • Meet the established credentialing productivity and quality department goals.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct