Lead Credentialing Coordinator

Tulane University

New Orleans, LA

JOB DETAILS
SKILLS
Accreditation Standards, Business Services, Communication Skills, Contract Negotiation, Customer Acquisition, Detail Oriented, Document Management, Documentation, Establish Priorities, Government, Health Insurance, Hospital, Leadership, Maintain Compliance, Managed Care, Microsoft Excel, Microsoft Word, National Committee for Quality Assurance (NCQA), Organizational Skills, People Management, Presentation/Verbal Skills, Project/Program Management, Provider Credentialing, Regulatory Compliance, Revenue Management, Time Management, Training/Teaching, Writing Skills
LOCATION
New Orleans, LA
POSTED
2 days ago

The Lead Credentialing Coordinator provider operational leadership and subject matter expertise for provider credentialing and enrollment activities across Tulane University Medical Group. This role ensures compliance with NCQA regulations compliance, supports revenue integrity, manage documentation and serves as a key resource for credentialing staff and internal stakeholders. Provide Management with the necessary data required in the negotiation of new contracts. Works with Business Services Staff in the resolution of provider enrollment/credentialing issues. Works in a highly complex environment with a multiple level of staff, management and physicians. Works with large volumes of data. Meets initial deadlines and follow up deadlines consistently. Interfaces with LCMC, HSC, TUSOM, and other vendors for delegated credentialing.

Tulane University is an equal opportunity educator and employer committed to providing an education and employment environment free of unlawful discrimination, harassment, and retaliation. Legally protected demographic classifications (such as a person's race, color, religion, age, sex, national origin, shared ancestry, disability, genetics, veteran status, or any other characteristic protected by federal, state, or local laws) are not relied upon as an eligibility, selection or participation criteria for Tulane's employment or educational programs or activities.

Tulane University is responsible for providing reasonable accommodations to individuals with disabilities throughout the applicant screening process. If you need assistance in completing an application or during any phase of the interview process, please contact the Office of Human Resources by phone at 504-865-4748 or by email at hr@tulane.edu.

REQUIRED QUALIFICATIONS:

  • Bachelor''s degree
  • 8-10+ years' relevant work experience

Any appropriate combination of relevant education, experience, and/or certifications that demonstrates the ability to perform the essential functions of the position may be considered.

PREFERRED QUALIFICATIONS

  • Familiarity with Managed Care Health Insurance Plans, especially credentialing procedures.
  • Experience with government payers, especially Provider Enrollment guidelines.
  • Excellent knowledge of required documentation for provider credentialing to Hospital Services Corporations and other outside credentialing agencies.
  • Ability to complete and maintain staff rosters with new enrollment and terminated providers for over 500+ providers .
  • Excellent oral and written communication skills.
  • Ability to work effectively with physicians and their staff members.
  • Detail-oriented with above average organizational skills in planning and prioritizing to meet deadlines.
  • Supervisory or leadership skills.
  • Project Management skills
  • Must be fluent in the use of Excel and Word.
  • Revenue Cycle experience in a Medical Group
  • Excellent oral and written communication skills.
  • Ability to work effectively with physicians and their staff members.
  • Detail-oriented with above average organizational skills in planning and prioritizing to meet deadlines.
  • Supervisory or leadership skills.
  • Project Management skills
  • Must be fluent in the use of Excel and Word.
  • Revenue Cycle experience in a Medical Group

About the Company

T

Tulane University