Medical Credentialing Analyst Jobs in Raleigh, NC

UNC Health is seeking a detail-oriented professional to join our Credentialing Team. This position is responsible for completing payer enrollment and facility appointment applications, tracking application progress, maintaining accurate provider records in credentialing software, managing credentialing files, and providing research and administrative support for special projects.
The ideal candidate will have strong written and verbal communication skills, excellent attention to detail, critical-thinking abilities, and proficiency with credentialing software such as CAQH and CredentialStream, as well as Microsoft Word and Excel. The successful candidate will be able to work independently with minimal supervision while collaborating effectively with providers, internal teams, and other stakeholders.
Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.
Summary:
Performs technical and administrative work involving the maintenance of a database of information and fourth-generation language programming (e.g., Access) and serves as the main information systems liaison between the department, ISD, other staff, and external vendors or organizations, ensuring that the systems are maintained and updated to meet the needs of the organization.
Responsibilities:
1. Compiles, formats, and prepares reports using various software packages, which includes researching and gathering data from multiple sources. Merges data or links databases, develops complex queries to extrapolate statistics and data from the database for ad hoc reports. Develops programs or other production criteria to develop the data reports requested or coordinates with the computer production staff to schedule production.
2. Defines the data dictionary based on the needs identified and defined by the users for the design of the application. Maintains the data dictionary as needs change or enhancements are added to systems.
3. Defines the data report needs of the users in the department. Responds to requests for information or data from outside the department or hospital via report, telephone, email and fax.
4. Ensures upgrades to the system are made. Evaluates and tests new applications or enhancements.
5. May perform special projects or assignments.
6. May supervise staff or oversee data input.
7. Provides training and support to end users regarding data collection, input, and analysis and/or in the use of new or changing applications systems. Assists staff and serves as a resource for others.
8. Responsible for the administration and maintenance of a database. Manages all aspects of data collection, data verification, data quality assurance and analysis. Establishes policies and procedures regarding the administration of the database.
9. Serves as the liaison between the end users of the data and ISD, external vendors or organizations, and/or other departments. Troubleshoots and resolves problems/issues at the system and user level.
Preferred Candidate will have experience using ECHO, CAQH or Credentialing Streams
Other Information
Other information:
Education Requirements:
• Bachelor's degree in relevant field
Licensure/Certification Requirements:
• No licensure or certification required.
Professional Experience Requirements:
• If a Bachelor's degree: One (1) year of experience in data system management.
• If an Associate's degree: Five (5) years of experience in data system management.
• If a High School diploma or GED: Nine (9) years of experience in data system management.
Knowledge/Skills/and Abilities Requirements:
Job Details
Legal Employer: NCHEALTH
Entity: UNC Health Medical Group
Organization Unit: Credentialing
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $23.24 - $33.41 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Hybrid
Work Schedule: Day Job
Location of Job: US:NC:Morrisville
Exempt From Overtime: Exempt: No
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.