Credentialing Coordinator 2

Brown Medicine; Providence (RI); Hybrid; USD 29,000 - 48,000; Full time

Job summary

Brown University Health is seeking a Credentialing Coordinator to manage credentialing processes for Brown Health Medical Group Primary Care providers in Providence, RI. The role ensures licensing, carrier credentialing, CAQH completion, DEA applications, and malpractice coverage are current.

You will maintain profiles in CAQH, NPPES, and Image Silo, prepare credentialing docs for facilities, and collaborate with Billing to resolve related issues.

Qualifications

• Experience with medical credentialing and licensing processes.
• Familiarity with CAQH, NPPES and provider databases.
• Ability to coordinate credentialing across multiple carriers.

Responsibilities

• Assists with applications for medical licensing and insurance credentialing.
• Maintains profiles in credentialing databases (Image Silo, CAQH, NPPES).
• Prepares credentialing applications for facilities and services.
• Coordinates with Billing to resolve credentialing payment issues.
• Tracks licenses, certifications and malpractice insurance.
• Provides provider numbers received from insurance carriers.
• Supports coverage rotations for reception duties.
• Performs other credentialing-related duties as assigned.

Skills

Credentialing

Licensing

CAQH

Billing coordination

Provider enrollment

Tools

Image Silo

CAQH

NPPES

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