Credentialing and Enrollment Professional
2 weeks ago
Tulane University Staff is seeking a highly skilled Credentialing and Enrollment Specialist to join our team. As a key member of our staff, you will be responsible for ensuring the smooth enrollment and credentialing process for our physicians in contracted Managed Care and Governmental Health Insurance Plans.
Key Responsibilities:
- Manage all activities related to enrollment/credentialing and re-enrollment/re-credentialing of physicians in contracted plans.
- Provide Management with necessary data for contract negotiations.
- Collaborate with Business Services Staff to resolve provider enrollment/credentialing issues.
- Work effectively in a complex environment with multiple stakeholders, including staff, management, and physicians.
- Meet deadlines consistently and work with large volumes of data.
- Interface with TUHC and credentialing vendors for delegated credentialing.
Requirements:
- High School Diploma
- 5 years of experience in Credentialing and Enrollment
- Familiarity with Managed Care Health Insurance Plans and credentialing procedures
- Experience with government payers and Provider Enrollment guidelines
- Excellent knowledge of required documentation for provider credentialing
- Ability to complete and maintain staff rosters with new enrollment and terminated providers for over 500+ providers
What We Offer:
- A dynamic and supportive work environment
- Opportunities for professional growth and development
- A competitive salary and benefits package
Selection Process:
- Selected candidates will undergo a background check and occupational health screening as a condition of employment
- A drug screening may be required for certain positions
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