Lead Credentialing Coordinator
About the role
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. The coordinator supplies management with data required for negotiating new contracts, resolves provider enrollment and credentialing issues with Business Services staff, and operates in a highly complex environment involving multiple levels of staff, management, and physicians. The role involves handling large volumes of data, meeting initial and follow-up deadlines, and interfacing with LCMC, HSC, TUSOM, and other vendors for delegated credentialing.
Responsibilities
- Demonstrate excellent oral and written communication skills.
- Work effectively with physicians and their staff members.
- Maintain a detail-oriented approach with above-average organizational skills in planning and prioritizing to meet deadlines.
- Apply supervisory or leadership skills.
- Utilize project management skills.
- Be fluent in the use of Excel and Word.
- Leverage revenue cycle experience in a medical group.
Requirements
- Bachelor’s degree.
- 8–10+ years of 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, particularly 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 500+ providers.