Provider Credentialing & Licensing Coordinator II

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

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.