Lead Credentialing Coordinator

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.  

• 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

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 .