Process Executive

1 week ago

Nagpur Maharashtra, India MedAce Business Solutions Pvt Ltd Full time

**Key Responsibilities**:

- **Credentialing**:

- Oversee the entire credentialing process for new and existing providers.
- Ensure all provider credentials are verified and maintained according to organizational policies and procedures.
- Coordinate with providers to obtain necessary documentation and information.
- Maintain accurate credentialing records in the credentialing database/system.
- Ensure compliance with state, federal and accrediting body requirements.

**2.Contract Management**:

- Prepare, review and manage contracts with providers, payers and other healthcare entities.
- Ensure contracts are compliant with organizational standards and regulatory requirements.
- Track contract terms, renewals and expirations.
- Collaborate with legal, compliance and finance departments to resolve contract issues.
- Maintain a comprehensive contract database and ensure all contracts are up-to-date.

**3.Compliance**:

- Stay informed about changes in regulations and accreditation standards related to credentialing and contracting.
- Conduct periodic audits of credentialing and contract records to ensure compliance.
- Assist in developing and updating policies and procedures related to credentialing and contracting.

**4.Communication and Collaboration**:

- Serve as a liaison between providers, payers and internal departments regarding credentialing and contract issues.
- Provide training and support to providers and staff on credentialing and contracting processes.
- Address and resolve provider inquiries and concerns in a timely manner.

**5.Reporting**:

- Generate regular reports on the status of credentialing and contracting activities.
- Present findings and recommendations to management as needed.
- Track and report key performance indicators (KPIs) related to credentialing and contracting processes.

**Job Types**: Full-time, Permanent, Fresher

Pay: ₹10,240.22 - ₹24,848.65 per month

**Benefits**:

- Provident Fund

Schedule:

- Fixed shift
- Monday to Friday
- Night shift
- US shift

Application Question(s):

- Are you a fresher?
- What is your salary expectations?

**Language**:

- English (preferred)

Work Location: In person

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