EHR Billing Credentialing Analyst - EHR

HealthRIGHT 360•Los Angeles, CA

About The Position

HealthRIGHT 360, a family of programs operating across 11 California counties, provides comprehensive medical and behavioral health services to marginalized communities. These services include primary care, mental health support, detoxification, substance use disorder treatment (residential and outpatient), and transitional services for individuals involved with the criminal justice system. The EHR department is crucial for ensuring the optimal functioning of all electronic health record systems and providing necessary user training and support. As a fast-paced, service-oriented department, the EHR team aims to empower all programs in delivering the best possible client services. The EHR Billing Credentialing Analyst is responsible for coordinating, maintaining, and monitoring provider credentialing and enrollment processes within the EHR system and associated payer platforms. This role involves close collaboration with clinical leadership, Human Resources, Compliance, Billing, and external agencies to ensure providers maintain active and compliant credentials, licenses, certifications, and payer enrollments necessary for service delivery and reimbursement. Key duties include maintaining provider records, tracking credentialing deadlines, supporting onboarding and recredentialing, validating provider data accuracy in EHR systems, troubleshooting credentialing-related system issues, and ensuring compliance with all relevant requirements. The analyst will also assist with implementations related to provider setup, workflows, and system integrations concerning credentialing and enrollment.

Requirements

Minimum of 3 years’ experience working in healthcare credentialing, provider enrollment, EHR systems, or healthcare administration OR Master’s degree or higher.
Experience with provider credentialing and payer enrollment processes.
Experience maintaining provider data within EHR systems and/or county systems.
Experience with compliance tracking, audits, and documentation management.
Knowledge of HIPAA and CFR 42.
High degree of accuracy, speed, and attention to detail.
Ability to multitask on projects and daily tasks while maintaining effective communication.
Ability to successfully prioritize.
Ability to work efficiently and productively in an independent manner.
Excellent verbal, written, and interpersonal skills.
Integrity to handle sensitive information in a confidential manner.
Strong organizational and documentation management skills.
Desire to learn and eagerness to elevate the efficiency of the department and agency.
Capable of obtaining and maintaining a satisfactory background check.
Applicants must not be on parole or probation due to funding regulations.
Qualified candidates with a criminal record will be considered for employment.
Capable of meeting credential requirements, if applicable.
Capable of meeting program requirements.

Nice To Haves

Experience with Help Desk or user support preferred.
Familiarity with Medi-Cal, county behavioral health systems, and payer credentialing requirements preferred.

Responsibilities

Maintain and organize provider credentialing records, licenses, certifications, DEA registrations, NPIs, and payer enrollment documentation within the EHR system.
Coordinate initial credentialing, recredentialing, and provider enrollment processes with payers, counties, and regulatory agencies.
Configure and maintain provider profiles, specialties, service locations, supervising relationships, and credentialing-related information in the EHR system.
Monitor credential expiration dates and ensure timely renewals to maintain provider compliance and uninterrupted billing capabilities.
Prepare and submit enrollment applications and supporting documentation for provider participation with counties, managed care plans, and other funding entities.
Conduct regular audits of provider data and credentialing records to ensure accuracy, completeness, and compliance.
Investigate and resolve credentialing discrepancies, missing documentation, enrollment delays, and provider setup issues.
Serve as an escalation resource for credentialing-related EHR support requests and technical issues.
Communicate and collaborate with EHR, Compliance, HR, Billing, Fiscal, and Clinical teams, as well as Counties, to ensure provider records remain accurate and compliant.
Attend and participate in department, inter-team, and agency meetings as appropriate.
Utilize problem-solving skills to improve credentialing workflows, tracking systems, and provider onboarding processes.
Assist EHR leadership with credentialing-related implementations, provider onboarding workflows, and system enhancements for new programs or funding streams.
Develop and maintain effective working relationships with clinical leadership, HR, compliance teams, and external credentialing entities.
Incorporate agency philosophy and mission in all aspects of job performance.
Maintain confidentiality regarding clients, providers, employees, and operations of the agency in accordance with HIPAA and 42 CFR Part 2.
Exercise good judgment in the performance of duties and responsibilities.
Other duties as assigned.