Credentialing Coordinator

 

The Credentialing and Medical Records Coordinator is a cross-functional support role within the Compliance & Quality Department, reporting to both the Senior Health Information Management Supervisor and the Senior Director of Quality and Risk,. This position is responsible for ensuring the accuracy, completeness, and integrity of documentation in our electronic and paper medical records systems and providing direct support to credentialing operations. This role plays a key part in maintaining high-quality standards and supporting compliance with documentation, data access, and regulatory requirements..

 

JOB FUNCTIONS:

Health Information Management Support:

· Supports daily Health Information Management (HIM) operations.

· Responds to release of information requests, audits, and investigations in a timely and professional manner.

· Manages and processes paper medical records stored both on- and off-site.

· Coordinates with the off-site storage vendor to retrieve or manage records.

EHR Oversight and Reporting:

· Runs scheduled and ad hoc reports from the Electronic Health Record (EHR) system to monitor documentation completion and accuracy.

· Assists staff in understanding and using report data to improve documentation.

· Leads EHR error correction efforts and tracks resolution timelines.

· Conducts access audits and monitors usage patterns of the EHR.

Training and Collaboration:

· Assists in training new and existing staff on EHR functionality and documentation expectations.

· Helps develop and update training materials related to EHR and HIM procedures.

· Collaborates with IT, Billing, and Program Managers to troubleshoot and resolve documentation-related issues.

Credentialing Support:

· Performs administrative support duties for credentialing processes.

· Assists in onboarding new staff by gathering and submitting required credentialing documentation.

· Serves as a liaison to the primary source verification vendor and tracks the progress of submitted credentials.

· Coordinates provider enrollment and roster management with contracted payers.

· Maintains credentialing and recredentialing records, ensuring licenses, certifications, and registrations remain current.

· Supports quality, compliance, operational, and financial initiatives through credentialing documentation and regulatory reporting.

· Assists with audits of clinical supervision documentation and compliance with organizational and regulatory requirements.

· Responds to internal and external inquiries from managers, staff, and regulatory bodies regarding credentialing.

Quality and Compliance Support:

· Contributes to department quality improvement and compliance initiatives.

· Participates in internal audits and special projects.

· Supports data validation and reporting related to quality measures and compliance indicators.

 

MINIMUM KNOWLEDGE AND SKILLS REQUIRED:

· Demonstrated ability to learn and master basic concepts of medical record-keeping requirements.

· Excellent communications skills, written and verbal.

· Excellent customer service skills.

· Able to follow directions and work independently and as a member of a team.

· Concurrently handle multiple tasks and carry out multiple short- and long-term projects.

· Perform detailed work accurately and take initiative to learn new tasks.

· Strong analytic, critical thinking, interpersonal, and organizational skills.

· Ability to maintain confidentiality and handle highly sensitive information with discretion.

· Intermediate proficiency with Office 365 applications.

· Occasional travel to programs

 

Education:

· Associate degree in human service, health care administration, business administration, or related field preferred.

 

Experience:

· 1 years’ experience in a health care or human service system preferred.