EHR Billing Credentialing Analyst EHR

JOB SUMMARYHealthRIGHT 360 a family of programs operates in 11 counties throughout California. Offering a comprehensive range of medical and behavioral health services HealthRIGHT 360 serves marginalized communities including primary care mental health support detoxification residential and outpatient substance use disorder treatment and transitional services tailored to individuals involved in the criminal justice Electronic Health Records (EHR) department is integral to our operations ensuring that all electronic health record systems function optimally and that all users receive the necessary training and support. As a fast-paced service-oriented department we aim to empower all programs in delivering the best possible client EHR Billing Credentialing Analyst is responsible for coordinating maintaining and monitoring provider credentialing and enrollment processes within the electronic health record (EHR) system and associated payer platforms. This position works closely with clinical leadership Human Resources Compliance Billing and external agencies to ensure providers maintain active and compliant credentials licenses certifications and payer enrollments required for service delivery and role includes maintaining provider records tracking credentialing deadlines supporting onboarding and recredentialing processes validating provider data accuracy within EHR systems troubleshooting credentialing-related system issues and ensuring compliance with county state federal and payer requirements. The EHR Billing Credentialing Analyst will also assist with implementations related to provider setup workflows and system integrations associated with credentialing and enrollment RESPONSIBILITIESCredentialing & Enrollment:Provider Credentialing Maintenance: Maintain and organize provider credentialing records licenses certifications DEA registrations NPIs and payer enrollment documentation within the EHR & Recredentialing Coordination: Coordinate initial credentialing recredentialing and provider enrollment processes with payers counties and regulatory Data Configuration: Configure and maintain provider profiles specialties service locations supervising relationships and credentialing-related information in the EHR Monitoring: Monitor credential expiration dates and ensure timely renewals to maintain provider compliance and uninterrupted billing Enrollment Support: Prepare and submit enrollment applications and supporting documentation for provider participation with counties managed care plans and other funding Validation & Auditing: Conduct regular audits of provider data and credentialing records to ensure accuracy completeness and Resolution: Investigate and resolve credentialing discrepancies missing documentation enrollment delays and provider setup Desk Escalation Support: Serve as an escalation resource for credentialing-related EHR support requests and technical & Collaboration: Communicate and collaborate with EHR Compliance HR Billing Fiscal and Clinical teams as well as the Counties to ensure provider records remain accurate and : Attend and participate in department inter-team and agency meetings as : Other duties as :Workflow Improvement: Utilize problem-solving skills to improve credentialing workflows tracking systems and provider onboarding : Assist EHR leadership with credentialing-related implementations provider onboarding workflows and system enhancements for new programs or funding :Relationships: Develop and maintain effective working relationships with clinical leadership HR compliance teams and external credentialing Philosophy and Mission: Incorporate agency philosophy and mission in all aspects of job : Maintain confidentiality regarding clients providers employees and operations of the agency in accordance with HIPAA and 42 CFR Part : Exercise good judgment in the performance of duties and other duties as Experience or CertificationRequired:Minimum of 3 years experience working in healthcare credentialing provider enrollment EHR systems or healthcare administrationORMasters degree or :Experience with provider credentialing and payer enrollment maintaining provider data within EHR systems and/or county with compliance tracking audits and documentation with Help Desk or user support of HIPAA and CFR with Medi-Cal county behavioral health systems and payer credentialing requirements and SkillsHigh degree of accuracy speed and attention to to multitask on projects and daily tasks while maintaining effective to successfully to work efficiently and productively in an independent verbal written and interpersonal to handle sensitive information in a confidential organizational and documentation management to learn and eagerness to elevate the efficiency of the department and Credentialing & Enrollment Management Coordinating and maintaining provider credentialing payer enrollment and recredentialing processes in compliance with regulatory and payer Provider Configuration & Maintenance Ability to configure and maintain provider records specialties licenses and credentialing-related information within the EHR Monitoring & Compliance Proficiency in monitoring expiration dates renewals and compliance requirements to ensure uninterrupted provider eligibility and billing Review & Audit Readiness Ability to organize review and audit provider documentation to ensure accuracy completeness and compliance with agency and payer Resolution & Problem-Solving Strong analytical and problem-solving skills to investigate credentialing discrepancies resolve enrollment issues and improve workflow Desk Support & Escalation Provide advanced support for credentialing-related EHR issues and assist users with troubleshooting and system -Department Communication & Collaboration Effective communication and collaboration with EHR HR Compliance Billing Fiscal and Clinical teams to support provider onboarding and Improvement & Process Optimization Ability to identify inefficiencies and implement improvements to credentialing tracking systems and operational & Compliance Commitment to maintaining confidentiality regarding provider client and operational information in accordance with HIPAA and CFR 42 Check and Other RequirementsCapable of obtaining and maintaining a satisfactory background must not be on parole or probation due to funding regulations. Qualified candidates with a criminal record will be considered for of meeting credential requirements if of meeting program requirements.