Credentialing and Medical Records Compliance Coordinator

University of California Riverside; Riverside (CA); On-site; USD 66,000 - 119,000; Full time

Job summary

The University of California, Riverside, seeks a Credentialing and Medical Records Compliance Coordinator to oversee vital compliance and credentialing processes in the Health Wellbeing and Safety division. This position is essential for maintaining regulatory adherence, liaising with various stakeholders, and ensuring safety measures across departments. Candidates should possess a Bachelor's degree and relevant experience, and be dedicated to upholding healthcare standards.

Qualifications

• 2 - 4 years of related experience required.
• Working knowledge of regulatory compliance methods and practices.

Responsibilities

• Manage credentialing, privileging, and medical records processes.
• Ensure compliance with accreditation and regulatory standards.
• Lead safety and emergency preparedness functions.

Skills

Regulatory compliance

Project management

Interpersonal communication

Analytical skills

Education

Bachelor's degree in clinical or related area

Job description

Credentialing and Medical Records Compliance Coordinator

Job ID:
Location: Main Campus - UCR
Schedule: 8AM - 5PM
Category: Healthcare
Salary: $66,500 - $118,300
Full/Part Time: Full-time(100%)
Organization: Health Wellbeing and Safety
Department: Jackie Rodriguez
Application Deadline: Open Until Filled

Position Information:
The Credentialing & Medical Records Compliance Coordinator plays a critical role in managing the credentialing, privileging, medical records, compliance, accreditation and safety & emergency preparedness functions within the Holistic Health Operations division, which includes clinical departments, Student Health Services (SHS), Counseling and Psychological Services (CAPS), Student Intervention and Follow-up Team (SWIFT), Athletics, and outside partnerships such as School of Medicine. This position ensures the integrity, confidentiality, and policy adherence of clinical documentation, credentialing, and privileging processes while leading safety & emergency response readiness for the departments. The coordinator serves as a key liaison between healthcare staff, UC Office of the President (UCOP), Human Resources (HR), and Credentialing Verification Organizations (CVOs), facilitating efficient, accurate, and policy-aligned operations.

The salary range for the Credentialing and Medical Records Compliance Coordinator is $66,500.00 - $118,300.00 annually. However, the expected pay scale for this position is up to $75,000.00 annually. We base salary offers on a variety of considerations, such as education, licensure and certifications, experience, and other business and organizational needs.

Applicants must have current work authorization when accepting a UCR staff position. Currently, we are unable to sponsor or take over sponsorship of an employment Visa for staff.

As a University employee, you will be required to comply with all applicable University policies and/or collective bargaining agreements, as may be amended from time to time. Federal, state, or local government directives may impose additional requirements.

Requirements:
Requirements

Educational Requirements

Bachelor's degree in clinical or related area, and/or equivalent combination of experience/training.

Required

Experience Requirements

2 - 4 years of related experience.

Required

Minimum Requirements

Working knowledge of the methods, tools, and practices involved with regulatory compliance.

Demonstrated knowledge and understanding of compliance and regulatory standards across the healthcare industry or within a specialty area.

Demonstrated project management skills and the ability to effectively manage time, organize competing priorities, address complex issues as they arise, and see projects through to completion on schedule.

Demonstrated interpersonal skills for collaborating effectively with a broad range of managers and staff and with representatives of external regulatory agencies.

Demonstrated skills in written and verbal communications, with the ability to convey complex technical information, education, and instructions in a clear and concise manner, and to produce high-quality reports and documentation.

Preferred Qualifications

Knowledge of UC credentialing process.


Additional Information:
Additional Information

In the Heart of Inland Southern California, UC Riverside is located on nearly 1,200 acres near Box Springs Mountain in Southern California; the park-like campus provides convenient access to the vibrant and growing Inland region. The campus is a living laboratory for the exploration of issues critical to growing communities' air, water, energy, transportation, politics, the arts, history, and culture. UCR gives every student, faculty and staff member the resources to explore, engage, imagine and excel.

UC Riverside is recognized as one of the most ethnically diverse research universities in the country boasting several key rankings of which we are extremely proud.

• UC Riverside is proud to be ranked No. 12 among all U.S. universities, according to Money Magazine's 2020 rankings, and among the top 1 percent of universities worldwide, according to the 2019-20 Center for World University rankings.
  


• UC Riverside is the top university in the United States for social mobility. - U.S. News 2020
  


• UCR is a member of the University Innovation Alliance, the leading national coalition of public research universities committed to improving student success for low-income, first-generation, and students of color.
  


• Among top-tier universities, UC Riverside ranks No. 2 in financial aid. - Business Insider 2019
  


• Ranked No. 2 in the world for research, UCR's Department of Entomology maintains one of the largest collections of insect specimens the nation. - Center for World University Rankings
  


• UCR's distinguished faculty boasts 2 Nobel Laureates, and 13 members of the National Academies of Science and Medicine.

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories under state or federal law. It is the policy of the University of California to undertake affirmative action and anti-discrimination efforts, consistent with its obligations as a Federal and State contractor.

For information about our generous employee benefits package, visit: Employee Benefits Overview

Job Description Details:
Job Description Details

General Information
Job Title
REGL HC SPEC 2 Job Code
004208 Grade
21 Department Head
Jackie Rodriguez Supervisor
Jackie Rodriguez

Generic Scope
Professional who applies acquired job skills, policies, and procedures to complete substantive assignments/projects/tasks of moderate scope and complexity; exercises judgment within defined guidelines and practices to determine appropriate action.

Custom Scope
Applies acquired skills and professional concepts for small to medium regulatory healthcare compliance projects of intermediate scope and complexity.

Department Custom Scope
The Credentialing & Medical Records Compliance Coordinator plays a critical role in managing the credentialing, privileging, medical records, compliance, accreditation and safety & emergency preparedness functions within the Holistic Health Operations division, which includes clinical departments, Student Health Services (SHS), Counseling and Psychological Services (CAPS), Student Intervention and Follow-up Team (SWIFT), Athletics, and outside partnerships such as School of Medicine. This position ensures the integrity, confidentiality, and policy adherence of clinical documentation, credentialing, and privileging processes while leading safety & emergency response readiness for the departments. The coordinator serves as a key liaison between healthcare staff, UC Office of the President (UCOP), Human Resources (HR), and Credentialing Verification Organizations (CVOs), facilitating efficient, accurate, and policy-aligned operations

Key Responsibilities:
Key Responsibilities DescriptionPercent Time

Under general supervision, collects and analyzes compliance monitors to identify risks of moderate scope. Prepares reports for ongoing compliance with internal policy and external agency requirements.

• Credentialing and Privileging: Primary point of contact for credentialing, re-credentialing, and privileging for SHS and CAPS and other units that reports in the Holistic Health Operations division. Works with the divisional leadership, administrative team (s) and governing board(s) to adhere to guidelines for credentialing /re-credentialing procedures, privileging criteria for Licensed Independent Providers and Allied Health Providers, documentation, and exceptional approval.
  
  Evaluate and validate documentation, privileges, peer reviews. Monitor screening requirements, eligibility, and manage privilege-specific evaluations and standardized procedure protocols. Escalate files of concern appropriately within the organization.
  
  Liaise with UC-wide Credentials Verification Organization and ensure compliance with UCOP guidelines.
  
  Lead the credentialing and privileging processes for new appointments and reappointments for health professionals and practitioners and initial applications for Other Healthcare Practitioners.
  
  Review RLDatix system entries for New Applicant requests and manage timely preparation and submission of credentialing files. Notify UCOP Risk Analyst upon new applicant submissions. Prepare applicants six months in advance of the RLDatix reappointment process. Communicate and escalate issues in regard to the RLDatix process.
  
  Manage accountability for credentialing system functionality and task assignments.
  
  Manage location accountability for licensure, certifications and insurance expirations monthly.
  
  Attend monthly UCOP Credentialing Meetings as a department representative. Coordinate credentialing communications across HR, CVO, UCOP, supervisors, directors, and credentialing committees, updating relevant policies and manuals as appropriate
  

50%

Under general supervision, ensures controls are in place at the organization for compliance with regulatory requirements affecting programs of moderate scope and complexity. Appropriate processes may include agendas, activity lists, tracer systems, and electronic record reviews.

• Medical Records Coordination: Maintain secure and compliant management of electronic and paper medical records, ensuring HIPAA and FERPA adherence and in alignment with respective professional and accreditation standards. Primary contact for medical records request and responding to subpoenas and Patient notices for SHS and support for CAPS. Keeps abreast of regulatory & compliance issues, plans for changes and / or integration as new healthcare affiliations are assumed. Maintains confidentiality and privacy in regard to patient records at all times.
  
  Monitors, audits and creates reports related to quality metrics and accreditation requirements, within the Electronic Medical Record (EMR) and reports to Executive Director and department leadership any quality, security or privacy-related issues. Conducts routine compliance audits for: operations, coding, HIPAA, and regulatory agency compliance and makes recommendations for process improvement and corrective actions.
  

20%

Under general supervision, identifies deficiencies and areas of noncompliance. Works on moderately-complex projects to review regulatory changes and improve integration of regulatory standards with healthcare and/or financial reimbursement programs.

• Regularly review healthcare provider credentialing files, medical records, and other related documentation to ensure compliance with institutional policies, state and federal regulations, and accreditation standards (HIPAA, FERPA, AAAHC, etc.).
  
  Utilize established compliance monitors to track key compliance areas such as licensing, certification, provider enrollment, and health record security. Conduct audits of healthcare provider credentials and medical records to verify that all necessary documentation is accurate and up to date. In collaboration with department leadership, supervisor, and Executive director, Identify areas of concern related to compliance and in coordination with leadership, take proactive steps to address issues before they become significant risks.
  

10%

Provides support on moderately-complex cross-functional tasks, projects, and programs.

• Emergency Preparedness: Serve in a rotating capacity on the Emergency Chair/BSEC for the Student Health and Counseling Center (SHCC) emergency preparedness and evacuation program. Lead or co-lead all SHCC emergency meetings, code drills, and in-service trainings. Maintain and update the emergency phone list and locator list. Coordinates with department personnel on matters that relate to emergency preparedness including escalation and communication with Holistic Health Divisional leadership.
  Safety: Conduct and document monthly fire extinguisher inspections for the building. Coordinate with the emergency shed coordinator to ensure emergency food, water and medical supplies are kept current and inventories updated Collaborate with Office of Emergency Management and emergency teams to ensure SHCC and department-wide emergency readiness and compliance. Ensures compliance and alignment with department safety plan for the Holistic Health division.

10%

Under general supervision, responds to questions in regards to regulatory compliance within areas of moderate scope and complexity. Contributes to educational activities and materials.

• Policy Compliance & Training: Enforce compliance with UC, state, and federal policies on credentialing, privileging, and recordkeeping in alignment with the respective disciplines. Train staff on documentation requirements, compliance workflows, and system use. Review and assist with policy development, audits, and regulatory inspections.

5%

Maintains databases to track data, activities, news, and events related to regulatory and compliance areas. Contributes to the development of new and updated reporting and system procedures.

• Collect and review compliance data related to credentialing processes and record-keeping procedures to identify areas of risk or noncompliance that could impact healthcare delivery, regulatory standing, or reimbursement eligibility.
  
  Prepare reports and findings from this analysis, highlighting risks that require corrective action or escalation. Compile and prepare regular reports on credentialing activities, medical records management, and compliance audits for internal stakeholders (such as Holistic Health Services leadership, administration, or legal teams).
  
  Develop and maintain detailed tracking systems for all credentialing processes, medical record audits, and corrective actions taken in response to compliance risks. Assist in the creation of compliance reports for external agencies, ensuring that documentation is thorough, accurate, and submitted in accordance with regulatory deadlines.

5%


To apply, visit https://jobsportal.ucr.edu/jobs/35219271







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