Credentialing Coordinator 2

CMPI Coastal Medical Physicians, Inc., d/b/a Brown Health Medical Group Primary Care; Chicago (IL); On-site; USD 44,000 - 72,000; Full time

Job summary

Brown University Health seeks a Credentialing Coordinator to manage licensing applications, insurer credentialing, CAQH completion, and hospital privileges for providers. You will maintain credentialing profiles in Image Silo, CAQH, and NPPES, and collaborate with Billing to resolve issues.

The role supports provider panels, tracks licenses and malpractice insurances, and may cover corporate receptionist duties as needed. Rhode Island location with standard work hours.

Qualifications

• Pay Range: $20.96–$34.61 per hour.
• Equal opportunity employer statements included in posting.

Responsibilities

• Assists new and existing providers with licensing applications and credentialing with insurers.
• Works with Practice Managers to ensure up-to-date provider panels and credentialing.
• Maintains profiles in credentialing databases such as Image Silo, CAQH, and NPPES.
• Prepares credentialing applications for imaging and laboratory facilities.
• Collaborates with Billing to resolve credentialing-related payment issues.
• Provides provider numbers received from insurers to Billing and Practice Managers.
• Tracks licenses, certifications, and malpractice insurance for providers.
• Maintains activity records in credentialing databases.
• Supports Corporate Receptionist coverage as needed.
• Performs other job-related duties as assigned.

Skills

Credentialing coordination

CAQH onboarding

Licensing applications

Billing coordination

Provider record tracking

Tools

Image Silo

CAQH interface

NPPES database

Job description

SUMMARY: Coordinates the credentialing processes with multiple insurance carriers, including obtaining malpractice insurance and assisting with the RI licensing and hospital privilege process for all Brown Health Medical Group Primary Care providers.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate

RESPONSIBILITIES

• Assists new and existing providers with completing applications for medical licensing, insurance carrier credentialing, CAQH completion, DEA application, malpractice insurance and hospital credentialing
• Ensures billing can be completed in a timely manner by working with the Practice Managers to maintain patient panels and ensure credentialing of providers is complete and up to date
• Creates and maintains profiles in Brown Health Medical Group Primary Care credentialing database, Image Silo, CAQH and NPPES (NPI database)
• Prepares credentialing applications for Imaging and Laboratory facilities and services
• Works collaboratively with the Billing Department to resolve credentialing related payment problems
• Provides Billing and Practice Managers with provider numbers received from insurance carriers
• Tracks provider licenses and certifications such as medical licenses, board certifications, DEA certificates, malpractice insurance and any other relevant documentation
• Maintains record of all activity pertaining to providers in credentialing database
• Participates in coverage rotation for the Corporate Receptionist role
• Performs other job-related duties as assigned

MINIMUM QUALIFICATIONS

Pay Range: $20.96-$34.61

EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location: BHCS 15 LaSalle Square - 15 LaSalle Square Providence, Rhode Island 02903

Work Type: M-F 8:00-4:30pm

Work Shift: Variable Daily Hours: Per Diem - As required

Driving Required: No

As Rhode Island's largest health system and private employer, Brown University Health is the state's premier provider of health services and includes the only Level I Trauma Center for southeastern New England. Today, more than 20,000 people work at Brown University Health and bring their unique skills, experiences, and compassion to their jobs every day. Formed in 1994, Brown University Health is a not-for-profit health system based in Providence, RI comprising three teaching hospitals of The Warren Alpert Medical School of Brown University: Rhode Island Hospital and its Hasbro Children's; The Miriam Hospital; and Bradley Hospital, the nation’s first psychiatric hospital for children; Newport Hospital, Saint Anne's Hospital and Morton Hospital, community hospitals offering a broad range of health services; Gateway Healthcare, the state’s largest provider of community behavioral health care; and Brown Health Medical Group, the largest multi-specialty practice in Rhode Island.

Brown University Health is an equal opportunity employer that values diversity of cultural background, race, gender, age, religion, identity, ability, and perspectives - we are actively committed to a diverse workforce that represents the patients and community that we serve. We are invested in creating a respectful, inclusive, and equitable environment that supports the holistic well-being of our employees and their families.

Join us and help build a healthier future for our patients - and for yourself.

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