Lead Credentialing Coordinator

Tulane University•New Orleans, LA

17d

About The Position

The Lead Credentialing Coordinator provides operational leadership and subject matter expertise for provider credentialing and enrollment activities across Tulane University Medical Group. This role ensures compliance with NCQA regulations, supports revenue integrity, manages documentation, and serves as a key resource for credentialing staff and internal stakeholders. This position provides management with the necessary data required in the negotiation of new contracts and works with Business Services Staff in the resolution of provider enrollment/credentialing issues. The role operates in a highly complex environment with multiple levels of staff, management, and physicians, and involves working with large volumes of data. The Lead Credentialing Coordinator must consistently meet initial and follow-up deadlines and interface with LCMC, HSC, TUSOM, and other vendors for delegated credentialing.

Requirements

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.

Nice To Haves

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.

Responsibilities

Provide operational leadership and subject matter expertise for provider credentialing and enrollment activities.
Ensure compliance with NCQA regulations.
Support revenue integrity.
Manage documentation.
Serve as a key resource for credentialing staff and internal stakeholders.
Provide management with necessary data for new contract negotiations.
Work with Business Services Staff to resolve provider enrollment/credentialing issues.
Interface with LCMC, HSC, TUSOM, and other vendors for delegated credentialing.
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.