Credentialing Coordinator

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:

CM-Providence-Coastal Medical Corporate Office-10 Davol Squa - 10 Davol Square Providence, Rhode Island 02903

Work Type:

8:00am-4:30pm

Work Shift:

Day

Daily Hours: 

8 hours

Driving Required:

No