Brown Medicine

Role Description Under the general supervision of the Chair of Neurology and Director of Neurology and according to established policies and procedures, administers the Brown Medical Faculty Administration faculty actions in the Department of Neurology and coordinates the Department of Neurology’s educational activities to include all Fellowship Educational programs, Continuing Medical Education and faculty development at Brown University Health. 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 In addition, our leaders will demonstrate an aptitude for: - Ensure Accountability and Build Effective Teams - Drive Vision and Purpose and Optimize Work Processes By applying core and leadership competencies, leaders help Brown University Health achieve its strategic goals. Responsibilities - Academic Administration: Under direction of the Chair of Neurology, responsible for initiating and completing all faculty actions required by the Alpert Medical School, including: - Medical academic searches in Interfolio - New hospital-based and community faculty and affiliate appointments - Senior promotions reviewed by the CMFA - Reappointments of hospital-based and community physicians following Brown BIOMED policies and procedures - Continuing Medical Education: In conjunction with faculty leadership, coordinates Neurology Department Continuing Medical Education programs, including: - Neurology Grand Rounds - Conferences and special symposia Collaborates with Continuing Medical Education Coordinator as necessary to ensure appropriate CME accreditation. Acts as a resource to program participants and other hospital staff, providing information regarding the continuing medical education programs. Serves as liaison to all levels of personnel within and outside the system regarding these particular programs. Participates in planning of specific departmental CME educational workshops, symposia and lecture series. - Faculty Development: Initiates, plans and directs faculty development programs to support the faculty's ability to teach, evaluate trainees and other faculty, ensuring that Brown University Medical School standards are met. Functions as administrative representative to the faculty regarding faculty development issues to ensure open communication and cooperation within the department. Performs administrative tasks related to Faculty Development Workshops, including: - Keeping a schedule of upcoming events - Identifying and booking rooms - Sending out advertisements of events - Keeping track of RSVPs - Filling out application for CME credits (if necessary) - Coordinating beverages/food for events Qualifications - Bachelor's degree required; Master’s degree preferred - Demonstrated outstanding written and oral communication skills - Strong attention to accuracy - Ability to think critically to prioritize multiple tasks and function independently - Knowledge of graduate medical education (fellowship), faculty development and continuing medical education in an academic setting Requirements - Minimum two years related experience developing educational programs Benefits - Pay Range: $25.51-$42.09 Company Description - Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Role Description Under the general supervision of the Principal Investigator(s) and Clinical Research Coordinator, assist in recruitment, acquisition, and analysis of patient information for multiple clinical research projects. Responsibilities include: - Interviews patients to gather information. - Prepares and maintains study records. - Enters data via computer. - Performs statistical analyses of resultant data. - Participates in qualitative/quantitative analyses of resultant data. - Reviews relevant literature to gather information. - May participate in the development of research protocols. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence. Additionally, all employees are expected to demonstrate the core Success Factors: - Instill Trust and Value Differences - Patient and Community Focus and Collaborate Qualifications - Bachelor’s Degree in Applied or Life Sciences or related area, including courses in research methodologies and microcomputer systems. - Three to six months on-the-job experience to become familiar with specific research studies. - Knowledge of theory and techniques of research methodology. - Organizational skills to organize and prioritize efforts on multiple projects. - Interpersonal skills to effectively interact with patients, families, and hospital professionals. - Analytical skills to participate in developing research protocols and perform statistical analyses. - Technical ability to operate and maintain computer systems. - Demonstrated knowledge and skills necessary to provide care considering aging processes, human development stages, and cultural patterns. Requirements - Often works within a specific department to identify, enroll, and follow up with research patients. - May spend much of the time standing and walking between departments, offices, Medical Records, etc. - Perform independently within the department’s policies and practices. - Refers specific complex problems to the supervisor when clarification of departmental policies and procedures are required. - No supervisory responsibility. Benefits - Pay Range: $19.97-$32.96 - 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. Company Description Location: The Miriam Hospital - 164 Summit Ave Providence, Rhode Island 02906 - Work Type: Varies - Work Shift: Variable - Daily Hours: 4 hours - Driving Required: No

Role Description Under supervision of the Manager Diagnostic Imaging Support Services, is responsible for the integrity of the pre-registration and prior authorization processes for outpatient radiological services within Brown University Health. Coordinates and arranges for all outpatient radiology orders to ensure patients have received financial clearance from insurance companies and troubleshoot as needed. 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 - Registers patients prior to scheduled appointments to obtain updated account information for accurate insurance billing. - Confirms patient eligibility with insurance carriers/third party payors and obtains pre-authorization requirements in accordance with established medical policies. - Coordinates and ensures appropriate insurance authorizations are obtained and/or received in a timely manner. - Reviews, recognizes, and understands clinical documentation from patient records pertinent to obtaining prior authorization as necessary. - Analyzes orders, authorizations, and records for discrepancies that may affect insurance coverage and/or denial of claims. - Notifies and coordinates with ordering physicians and providers when peer-to-peer discussions are required to obtain prior authorization of services being denied by patients’ insurance. - Professionally communicates with various Brown University Health personnel to resolve billing issues, authorization denials, and financial clearance of patient appointments. - Provides mature, quality customer service to patients, their families, and/or their representatives. - Ensures all patients are financially cleared by insurance/third party payor prior to their scheduled appointments. - Performs other duties as assigned. Qualifications - High school diploma or equivalent required. - Knowledge of business systems, office procedures, computer skills, medical terminology, and health insurance processes/terminology including, but not limited to, CPT and ICD-10 coding. - Strong organizational skills, critical thinking, and focus to detail required to manage high volume of radiologic orders requiring prior authorization and/or financial clearance. - Analytical skills to evaluate effectiveness of work flow with the ability to make recommendations, develop, and adapt to changes as necessary. - Interpersonal skills necessary to provide effective communication with patients and other healthcare professionals within and outside of Brown University Health. Requirements - Two years of previous experience in health care environment with emphasis in health insurance billing and reimbursement, healthcare operations, database management, and patient/provider interaction. - Normal office environment; may experience some visual fatigue as a result of extended periods of work on the computer. - Performs independently within the department’s policies and practices. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required. - None supervisory responsibility. Benefits - Pay Range: $19.03-$31.39 - 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: Remote-Massachusetts - N/A Boston, Massachusetts 02108 - Work Type: M-F 9:30am - 6:00pm occasional weekends - Work Shift: Day - Daily Hours: 8 hours - Driving Required: No

Role Description Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. 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 - Review all denied claims, correct them in the system and send corrected appealed claims as written correspondence, fax or via electronic submission. - Identify and analyze denials and enact corrective measures as needed to effectively communicate and resolve payer errors. - Continually maintain knowledge of payer specific updates via payer’s listservs, provider updates, webinars, meetings and websites. - Understand and maintain compliance with HIPAA guidelines when handling patient information. - Contact internal departments to acquire missing or erroneous information on a claim resulting in adjudication delays or denials. - Report to supervisor identification of denial trends resulting in revenue delays. - Answers telephone inquiries from 3rd party payers; refer all unusual requests to supervisor. - Retrieve appropriate medical records documentation based on third party requests. - Refer all accounts to supervisor for additional review if the account cannot be resolved according to normal procedures. - Work with management to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department. - Maintain quality assurance, safety, environmental and infection control in accordance with established policies, procedures, and objectives of the system and affiliates. - Perform other related duties as required. Qualifications - Equivalent to a high school graduate. - Knowledge of 3rd party billing to include ICD, CPT, HCPCS and 1500 claim forms. - Demonstrated skills in critical thinking, diplomacy and relationship-building. - Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings. - Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. Requirements - One to three years of relevant experience in professional billing preferred. - Experience with Epic a plus. - Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action. - None supervisory responsibility. Benefits - Pay Range: $19.97-$32.96 - 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: Monday-Friday 7:30-4 - Work Shift: Day - Daily Hours: 8 hours - Driving Required: No

Role Description Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. 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 - Review all denied claims, correct them in the system and send corrected appealed claims as written correspondence, fax or via electronic submission. - Identify and analyze denials and enact corrective measures as needed to effectively communicate and resolve payer errors. - Continually maintain knowledge of payer specific updates via payer’s listservs, provider updates, webinars, meetings and websites. - Understand and maintain compliance with HIPAA guidelines when handling patient information. - Contact internal departments to acquire missing or erroneous information on a claim resulting in adjudication delays or denials. - Report to supervisor identification of denial trends resulting in revenue delays. - Answers telephone inquiries from 3rd party payers; refer all unusual requests to supervisor. - Retrieve appropriate medical records documentation based on third party requests. - Refer all accounts to supervisor for additional review if the account cannot be resolved according to normal procedures. - Work with management to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department. - Maintain quality assurance, safety, environmental and infection control in accordance with established policies, procedures, and objectives of the system and affiliates. - Perform other related duties as required. Qualifications - Equivalent to a high school graduate. - Knowledge of 3rd party billing to include ICD, CPT, HCPCS and 1500 claim forms. - Demonstrated skills in critical thinking, diplomacy and relationship-building. - Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings. - Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies. Requirements - One to three years of relevant experience in professional billing preferred. - Experience with Epic a plus. Pay Range $19.97-$32.96 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 Monday-Friday 7:30-4 Work Shift Day Daily Hours 8 hours Driving Required No

Role Description The Hospital Credentialing Coordinator reports to the Credentialing Manager Patient Financial Services. Under general supervision and within Brown University Health policies and procedures performs credentialing and/or re-credentialing of hospital-employed physicians and other ancillary providers for Brown University Health facilities. 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 - Initiates the application process by distributing the credentialing application packet and hospital criteria to applying physicians. - Completes collection and process application for initial appointment, reappointment, and additional privileges for all credentialed practitioners. - Obtains primary source verification (verifying all elements of application directly with the source-such as medical school, residency program, previous hospitals, licensing board, and any other required source). - Maintain credentialing database. - Conducts ongoing monitoring and verification of license, malpractice insurance, DEA certificate, and board certification for all applicable practitioners. - Conducts ongoing monitoring of sanctions or disciplinary actions such as license and Medicare sanctions. - Maintains active and archived credentialing files. - Performs delegated credentialing for health plans. - Assists in preparation and participate in the credentialing verification portion of accreditation and regulatory surveys. - Assists in the development of policies and procedures. - Develops and maintains effective working relationship with other personnel, including physicians, support staff, billing staff, insurers and department administrative personnel to expedite information exchange and resolution of common issues. - Receives and answers all questions relative to third-party credentialing within scope of responsibility. - Adhere to production goals and directives. - Assists in auditing delegated credentialing functions in accordance with policies and procedures. - Audits files for completed information upon submission, requests missing data from providers. - Coordinates with client health plan to ensure practitioner/hospital credentialing and enrollment lag time is at minimum levels; serve as primary liaison with client health plan for any practitioner/hospital database issues. - Participates on special projects as needed to evaluate health plan operational requirements and reimbursement. - Researches practitioner/organization issues such as payment denials due to plan participation status, practitioner specialty and service locations and notifies appropriate parties. - Responsible for National Provider Identifier (NPI) number generation/tracking and revisions. - Creates, and or updates existing Counsel for Affordable Quality Healthcare (CAQH) profiles. Updates should automatically be completed ensuring continuous participation with established third party payers. - Reminds staff of when licensing renewals are due. - Documents Tracking/Dissemination. - Forwards renewed credentials to all your affiliations to minimize repeated request for credentialing related documents. - Responsible for monitoring status and immediately reporting to Manager those who do not meet the standard established by the Joint Commission. - Assists in the accurate and timely completion of Electronic Data Interchange (EDI) enrollments for electronic submission with various payors and clearinghouses, including status follow up. - Creates a common understanding of the initial credentialing and recredentialing processes so those involved in credentialing activities have a better sense of what it is all about, why it is important, and what they can expect from health plans and hospitals. - Maintains strong knowledge of managed care systems and contract related activities, including legal, regulatory and operation requirements. - Remain current with National Committee for Quality Assurance (NCQA) and Centers for Medicare and Medicaid Services (CMS) standards to assist organization with ongoing contractual and regulatory compliance. - Stays abreast of latest credentialing developments, trends and techniques. - Performs other duties as assigned. Qualifications - Associates Degree in Health Services or related field preferred or equivalent combination of education and experience. - Minimum of three years relevant experience working in a Hospital, physician office or multi-entity credentialing environment. - Successful experience demonstrating the use of interpersonal skills necessary to communicate and gather information from all levels of personnel and the ability to handle highly confidential data in a secure and trustworthy manner. - Knowledge of credentialing principles for Hospitals/provider networks/payers. - Intermediate computer skills, credentialing software and information systems knowledge; ability to generate management and production reports, documents and correspondence independently. - Current knowledge of Joint Commission requirements, state regulations and credentialing processes. - Continuing education in federal and regulatory education related to credentialing as required. - Current knowledge of NCQA and Medicare credentialing standards and other regulatory requirements. - Normal working environment with little to no exposure to any adverse environmental conditions. Benefits - Pay Range: $20.96-$34.61 Company Description - Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

• Review outpatient clinical documentation to assign ICD-10-CM and CPT codes • Use 3M 360 Finder for code assignment and claim edits resolution • Ensure medical records support code assignment • Monitor outpatient uncoded reports for timely coding • Report documentation insufficiencies to responsible physician • Update patient financial accounts in billing system as required

Role Description Performs coder and provider audits of ICD-10 codes, CPT codes, HCPCS codes and HCC’s. Prepares training materials and provides education as needed. Stays abreast of industry and payer changes pertaining to coding and documentation guidelines. - Audit professional ambulatory medical records (inpatient visits, outpatient visits, medication administration, surgeries and office/clinic procedures) to ensure billed codes are accurately supported by the documentation. - Possess knowledge of teaching physician regulations, including incident to, split shared and attestation requirements. - Review diagnoses, procedures and modifiers assigned by coders, and record outcomes. Share completed audit results with Validation Team Leadership who will relay results to Coding Manager and/or Director so they can provide feedback to the individual coders, as needed. - Review diagnoses and procedures assigned by providers and record outcomes. Share completed audit results with Validation Team Leadership who will relay results to individual providers and provider leadership. - Review medical records for hierarchal condition coding (HCC’s) in advance of patient visits to identify chronic conditions that the provider may want to assess. - Stay abreast of coding and documentation guidelines, compliance policies, annual coding updates, payer policies and industry changes. Utilize this knowledge in day to day workload. - Identify coding/documentation trends that may pose a risk to Brown University Health or its revenue stream and report such trends to management team. Recommend improvements to documentation templates in Epic that will minimize compliance risk and facilitate accurate documentation for the providers. Assure documentation is defensible in the event of an external audit. - Work with Practices/Clinics, Providers, Coding Team, Corporate Compliance, Risk Management, Contracting and Payers to help assure that all departments are consistently on the same page and able to provide accurate feedback to coders and providers. - Abides by the Standards of Ethical Coding as set forth by the American Academy of Professional Coders and American Health Information Management Association. - Performs other duties as assigned. Qualifications - Associate degree and/or successful completion of coding certification program. - Understanding of the content of the medical record. - Trained in medical terminology, medical science, anatomy and physiology. Requirements - Five years coding experience, preferable in a large, academic practice/facility. Past auditing experience or strong background in coding preferred. - Ability to recognize and understand clinical documentation pertinent for coding. - Good writing skills to communicate coding/documentation issues clearly. - Computer literate; capable of researching websites to access regulatory requirements. - Ability to navigate the patient electronic medical record. Working Condition and Physical Requirements - Normal office environment. Independent Action - Performs independently within the department’s policies and procedures. Refers specific complex problems to the manager when clarification of the departmental policies and procedures are required. Supervisory Responsibility - Leads and coordinates the daily work of assigned staff, providing direction, training, and support as needed. Pay Range $67,724.80-$111,716.80 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 BHCS 15 LaSalle Square - 15 LaSalle Square Providence, Rhode Island 02903 Work Type M-F 8:00 AM to 4:30 PM Work Shift Day Daily Hours 8 hours Driving Required No

• Review study protocols, consent forms, and manuals to extract relevant information to develop resources for the clinical team. • Develop and configure clinical research documentation. • Utilize study start up documents to initiate therapeutic EMR treatment plan creation. • Collaborate with Principal Investigator, clinical staff and pharmacy to gather requirements and ensure documentation and treatment plans meet clinical needs. • Create and distribute Letters of Collaboration with multiple departments as needed. • Troubleshoot and resolve issues related to clinical documents, treatment plans, and Letters of Collaboration. • Maintain all documentation dispersed to clinical team. • Participate in departmental meetings with regulatory and pharmacy. • Perform additional responsibilities as necessary.

Role Description Reports to the Coding Manager. Reviews the outpatient clinical documentation of extract data and assigns appropriate ICD-10-CM and CPT codes in accordance with the outpatient ICD-10-CM Official Guidelines for Coding and Reporting and the AHA HCPCS Coding Clinics. Reviews the medical records to ensure the documentation supports the code assignment. Utilizes 3M 360 Finder for code assignment and appropriate resolutions of claim edits (CCI, NCD, OCE, etc.). Confers with physician for clarification as needed. Monitors outpatient uncoded report to ensure timely coding and billing process. Maintains and meets HIS quality and productivity standards. 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 - Enters coded abstracted information into 3M 360 Finder assigning accurate APC and reviewing all coding edits appearing in 3M. - Understands and follows all National Correct Code Initiative Edits (NCCI) and follows pertinent medical necessity requirements. - Resolves accounts on the claims edit database. - Assigns injections and infusion codes for observation patients. - Meets the minimum productivity standard maintaining an average accuracy rating of 95%. - Assigns E/M, ICD-10-CM, CPT or chargemaster codes to clinic visits ensuring medical record documentation supports the code. - Ensures accuracy of diagnosis, ICD or CPT codes entered by physicians and supports them with documentation in the medical record. - Utilizes 3M to identify and resolve NCCI edits before final billing. - Reports documentation insufficiencies to the responsible physician. - Follows Rhode Island Hospital Facility Coding Guidelines for adult patients and 1995 Evaluation and Management Guidelines for patients less than 18 years of age. - Monitors and resolves rejected accounts on the Claims Edit Report and e Clinical Works error reports by established timeframe. - Researches coding conflicts including chargemaster, medical necessity, and various other coding and billing issues. - Refers complex coding issues to the coding validator or supervisor. - Reviews pertinent outpatient uncoded reports researching and resolving old uncoded accounts. - Updates patient financial accounts in the Patient Management and Patient Accounting billing system as required. - Follows established procedures for rebilling accounts. - Performs related clerical duties as required. - Maintains level of knowledge and expertise pertinent to the position. Qualifications - High school diploma or equivalent. - Successful completion of formal coding educational program. - Ability to read and understand outpatient clinic medical record documentation for reporting of outpatient clinic, ancillary, and endoscopies. - Coding certification required from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC). - One to two years experience in outpatient coding or billing. - Ability to meet and maintain established quality and productivity standards. Requirements - Requires long periods of sitting to review medical records. - Ability to lift a minimum of 25 pounds, bend, stoop, stretch, use step-stools to file records. - Ability to work under stressful conditions to maintain accounts receivable days achieving productivity and accuracy. - Performs independently within the department’s policies and practices. - Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required. Benefits - Pay Range: $24.29-$40.07 - 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: Remote-Rhode Island - N/A Providence, Rhode Island 02901 - Work Type: 8:00am-4:30pm - Work Shift: Variable - Daily Hours: 8 hours - Driving Required: No