Senior Credentialing Coordinator

Tulane University

LA

JOB DETAILS
SKILLS
Accreditation Standards, Business Services, Contract Negotiation, Customer Acquisition, Documentation, Government, Health Insurance, Hospital, Managed Care, Organizational Skills, People Management, Physician Credential, Provider Credentialing, Time Management, Training/Teaching
LOCATION
LA
POSTED
13 days ago

Responsible for all activities related to enrollment/credentialing and re-enrollment/ re-credentialing of all physicians in contracted Managed Care and Governmental Health Insurance Plans. 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. Work with large volumes of data. Meets initial deadlines and follow up deadlines consistently. Interfaces with TUHC and credentialing 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.Minimum Qualification:

  • High School Diploma
  • 5 years Credentialing and Enrollment work experience

Preferred Qualification:

  • 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

About the Company

T

Tulane University