Credentialing Coordinator 2

Lifespan; Town of Providence (NY); On-site; USD 29,000 - 48,000; Full time

Job summary

Brown University Health coordinates provider credentialing, licensing, and insurance carrier enrollment, ensuring timely CAQH submissions and DEA applications. The role tracks licenses, malpractice coverage, and hospital privileges while maintaining credentialing databases such as Image Silo and NPPES.

Responsibilities include assisting providers, supporting billing in credentialing matters, and coordinating with practice managers to keep provider panels current.

Qualifications

• Assists providers with medical licensing applications, credentialing, CAQH completion, and DEA applications.
• Manages malpractice insurance and hospital credentialing processes for providers.
• Maintains and updates credentialing data in relevant databases and systems.

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

Skills

Credentialing

CAQH

NPPES

DEA applications

Medical licensing

Malpractice insurance

Billing coordination

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:

Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903

Work Type:

per diem

Work Shift:

Variable

Daily Hours:

Per Diem - As required

Driving Required:

No