Credentialing Specialist
1 day ago
Under the general supervision of the Credentialing Manager, this role performs a variety of clerical and administrative functions to provide support and assistance in day-to-day activities of the Patient Financial Service Credentialing Department. The ideal candidate will have a high school level of knowledge or equivalent, with a minimum of one to two years of experience in credentialing and/or privileging within a hospital or managed care environment.
Key Responsibilities- Receives and audits incoming requests for enrollment and provider documentation.
- Answers phone calls from providers, practice managers, directors, and health plans.
- Handles and resolves provider/practice manager complaints and inquiries via email or phone.
- Processes customer and account source documents by reviewing data for deficiencies and resolving discrepancies.
- Prepares source data for database entry by compiling and sorting information, establishing entry priorities, and entering provider data in the requested format.
- Verifies entered customer and account data by reviewing, correcting, deleting, or reentering data.
- Maintains provider records in the credentialing database by entering new and updated customer and account information.
- Reports needed changes for processes and process improvement.
- Maintains customer confidence and protects operations by keeping information confidential.
- Maintains productivity measures/quality measures as defined by the Credentialing Department.
- Maintains quality assurance, safety, environmental, and infection control in accordance with established system policies, procedures, and objectives.
- Contributes to team effort by accomplishing related results as needed.
- Assists PFS Credentialing staff in their absence, responding and/or forwarding incoming requests, answering phones, taking messages, and assisting with departmental functions.
- Participates in educational programs as directed.
- High school level of knowledge or equivalent required.
- Minimum one to two years of experience in credentialing and/or privileging within a hospital or managed care environment.
- Must have at least one year of experience in a healthcare office environment.
- Proven expertise in the healthcare physician credentialing, expirables management, re-credentialing, and provider enrollment environment.
- Highly motivated and success-driven with the ability to implement and manage cross-functional projects.
- Proficient in Microsoft Office and knowledge of Intellicred credentialing software or other electronic credentialing systems is helpful but not required.
- Strong organizational and excellent follow-up skills.
- Ability to interact effectively with a variety of people (physicians and medical staff offices).
- Provide highest level of customer service for both internal and external customers.
- Strong written and verbal communication skills.
- Strong presentation and client interaction skills.
Brown University Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, ethnicity, sexual orientation, ancestry, genetics, gender identity, or expression, disability, protected veteran, or marital status.
-
Credentialing Specialist
2 days ago
Providence, Rhode Island, United States Lifespan Full timeJob SummaryWe are seeking a highly motivated and detail-oriented Credentialing Specialist to join our team at Lifespan. As a Credentialing Specialist, you will play a critical role in ensuring the accuracy and completeness of provider data in our credentialing database.ResponsibilitiesVerify and update provider information in our credentialing database,...
-
Credentialing Specialist
2 days ago
Providence, Rhode Island, United States Brown University Health Full timeJob SummaryWe are seeking a highly motivated and detail-oriented Credentialing Specialist to join our team at Brown University Health. As a Credentialing Specialist, you will play a critical role in ensuring the accuracy and completeness of provider data in our credentialing database.Key ResponsibilitiesReceive and process incoming requests for provider...
-
Credentialing Specialist
2 weeks ago
Providence, Rhode Island, United States Lifespan Full timeJob SummaryWe are seeking a highly motivated and detail-oriented Credentialing Specialist to join our team at Lifespan. As a key member of our Patient Financial Service Credentialing Department, you will play a critical role in ensuring the accuracy and completeness of provider data in our credentialing database.Key ResponsibilitiesReceive and process...
-
Credentialing Coordinator
3 weeks ago
Providence, Rhode Island, United States Lifespan Health System Full timeCredentialing Specialist Job DescriptionUnder the general supervision of the Credentialing Manager, performs a variety of clerical and administrative functions to provide support and assistance in day-to-day activities of the Patient Financial Service Credentialing Department.Key Responsibilities:Supports the Credentialing Manager in maintaining accurate and...
-
Credentialing Coordinator
7 days ago
Providence, Rhode Island, United States Lifespan Health System Full timeCredentialing Specialist Job DescriptionUnder the general supervision of the Credentialing Manager, performs a variety of clerical and administrative functions to provide support and assistance in day-to-day activities of the Patient Financial Service Credentialing Department.Key Responsibilities:Supports the Credentialing Manager in maintaining accurate and...
-
Vascular Imaging Specialist
4 weeks ago
Providence, Rhode Island, United States CharterCARE Health Partners Full timeJob SummaryWe are seeking a skilled Vascular Imaging Specialist to join our team at CharterCARE Health Partners. As a key member of our vascular lab, you will be responsible for performing clinical examinations and other tasks assigned by the Lead Vascular Technologist.ResponsibilitiesPerform clinical examinations and other tasks assigned by the Lead...
-
Diagnostic Imaging Specialist
1 week ago
Providence, Rhode Island, United States Women & Infants Hospital Full timeJob SummaryThe Diagnostic Imaging Specialist interprets physician's orders and performs diagnostic radiography and CT Scans, demonstrating expertise in the use of equipment. The ideal candidate will prepare equipment, correctly position patients, and apply proper techniques for procedures. Additionally, they will prepare required reports and documentation,...
-
Optometrist - Eye Care Specialist
2 weeks ago
Providence, Rhode Island, United States AEG Full timeAbout the JobThe Eye Care Specialist will conduct comprehensive eye exams for Acuity Eyecare Group and strive to practice to the full capacity of their license. The Eye Care Specialist will support practice growth by establishing strong patient relationships and educating patients on eye care best practices.Duties and ResponsibilitiesConduct thorough eye...
-
Providence, Rhode Island, United States Women & Infants Hospital Full timeJob Summary:The Clinical Practice Manager/Clinical Nurse Specialist (CPM/CNS) serves as a professional role model, expert consultant, educator, and resource in managing and developing clinical nursing practice. This individual demonstrates excellence in clinical nursing by assessing, planning, designing, organizing, implementing, and evaluating professional...
-
Providence, Rhode Island, United States Women & Infants Hospital Full timeJob SummaryThe Clinical Practice Manager/Clinical Nurse Specialist (CPM/CNS) is a key professional role model, expert consultant, educator, and resource in managing and developing clinical nursing practice. In collaboration with the nursing director/manager and nursing staff, this individual assesses, plans, designs, organizes, implements, and evaluates the...
-
Canine Training Specialist
2 months ago
Providence, Rhode Island, United States Crossbones Dog Academy Full timePosition OverviewAre you passionate about canine education and behavior?As a Canine Training Specialist, you will:Engage in the rewarding experience of training dogs and educating their owners.Utilize a positive reinforcement methodology, adhering to the LIMA (Least Intrusive, Minimally Aversive) principles of dog training.Conduct various training formats,...
-
Providence, Rhode Island, United States Women & Infants Hospital Full timeJob Summary:The Clinical Practice Manager/Clinical Nurse Specialist (CPM/CNS) serves as a professional role model, expert consultant, educator, and resource in managing and developing clinical nursing practice. This individual demonstrates excellence in clinical nursing by assessing, planning, designing, organizing, implementing, and evaluating professional...
-
Providence, Rhode Island, United States Women & Infants Hospital Full timeJob Summary:The Clinical Practice Manager/Clinical Nurse Specialist (CPM/CNS) serves as a professional role model, expert consultant, educator, and resource in managing and developing clinical nursing practice. This individual demonstrates excellence in clinical nursing by assessing, planning, designing, organizing, implementing, and evaluating professional...
-
Optometrist - Eye Care Specialist
1 week ago
Providence, Rhode Island, United States AEG Full timeAbout the JobThe Eye Care Specialist will conduct comprehensive eye exams for AEG and strive to practice to the full capacity of their license. The Eye Health Professional will support practice growth by establishing patient relationships and education to the patient on eye care.Duties and ResponsibilitiesConducting thorough eye exams to diagnose sight...
-
Providence, Rhode Island, United States Women & Infants Hospital Full timeJob Summary:The Clinical Practice Manager/Clinical Nurse Specialist plays a pivotal role in advancing clinical nursing practice, serving as a professional role model, expert consultant, educator, and resource. In collaboration with nursing leadership and staff, this individual assesses, plans, designs, organizes, implements, and evaluates professional...
-
Pharmacy Specialist
2 months ago
Providence, Rhode Island, United States LifeSpan Full timeJob SummaryWe are seeking a highly skilled and experienced Pharmacy Specialist to join our team at LifeSpan. The successful candidate will be responsible for performing sterile compounding of medications, primarily oncology, in compliance with United States Pharmacopoeia (USP) Chapter Hazardous Drugs, USP Chapter Pharmaceutical Compounding - Sterile...
-
Pharmaceutical Specialist
2 days ago
Providence, Rhode Island, United States Brown University Health Full timeJob SummaryWe are seeking a highly skilled and experienced Pharmaceutical Specialist to join our team at Brown University Health. As a key member of our pharmacy team, you will be responsible for performing complex pharmacy-directed technical functions to assist with coordinating operations and processes relating to compounding and dispensing of oncology and...
-
Travel Nurse Position
4 weeks ago
Providence, Rhode Island, United States Travel Nurse Source Full timeER/Trauma RN Job OpportunityWe're working with QS Nurses to find a qualified ER/Trauma RN in Warwick, Rhode Island.About the PositionQS Nurses is looking for a skilled and experienced ER/Trauma RN to join their team.Key ResponsibilitiesProvide high-quality patient care in the ER/Trauma departmentCollaborate with the healthcare team to ensure effective...
-
Physical Therapist in New Jersey
1 day ago
Providence, Rhode Island, United States AB Staffing Full timeAre you a skilled Physical Therapist looking for a new challenge? At AB Staffing, we specialize in placing Allied Health providers in facilities across the United States. Our travel assignments range from three to twelve months, giving you the opportunity to broaden your horizons and choose a different adventure. Our dedicated and experienced staffing...
-
Travel Nurse RN Position
1 month ago
Providence, Rhode Island, United States LanceSoft Full timeJob DetailsLanceSoft is seeking a skilled travel nurse RN for a Med Surg position in a reputable healthcare facility.Job RequirementsSpecialty: Med SurgDiscipline: RNDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelAbout LanceSoftLanceSoft is a Certified MBE and Woman-Owned organization with a strong reputation in the...
