Provider Enrollment Coordinator

Summary

Responsible for providing administrative support to the credentialing program ensuring that medical staff members maintain current credentials and licenses to work legally in their field or specialty. Responsible for monitoring upcoming renewal dates and working with medical staff to advise them of the required steps to maintain their credentials.

Does this position require Patient Care? No

• Reviews and screens initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, local and company regulations, guidelines, policies, and standards.
• Conducts primary source verification, collects and validates documents to ensure accuracy of all credentialing elements; assesses completeness of information and qualifications relative to credentialing standards.
• Identifies, analyzes and resolves extraordinary information, discrepancies, time gaps and other idiosyncrasies that could adversely impact ability to credential and enroll practitioners.
• Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies.
• Enters, updates and maintains data from provider applications into credentialing database.
• Prepares, issues, electronically tracks and follows-up on appropriate verifications for efficient, high-volume processing of individual applications in accordance with applicable credentialing standards.
• Prepares reports and scoring required by regulatory and accrediting agencies, policies and standards.

Bachelor's Degree Related Field of Study preferred

Experience in Clinical/Medical Office/Healthcare 1-2 years required and Credentialing/Accreditation Experience 1-2 years preferred

• Knowledge of medical provider credentialing and accreditation principles, policies, processes, procedures, and documentation.
• Working knowledge of clinical and/or hospital operations and procedures.
• Ability to use independent judgment and to manage and impart confidential information.
• Skill in establishing priorities with independent coordination of day-to-day aspects.
• Ability to communicate effectively both orally and in writing.
• Information research skills.

Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.