Credentialing Executive
5 days ago
**Key Responsibilities**:
**1. Credentialing Process Management**: Oversee and manage the end-to-end credentialing process for healthcare providers, including physicians, nurses, and allied health professionals. Ensure each provider is verified against applicable legal and regulatory requirements.
**2. Documentation & Compliance**: Ensure that all provider documentation, such as licenses, certifications, and training records, are complete, accurate, and submitted in accordance with state, federal, and institutional guidelines.
**3. Database Management**: Maintain and regularly update credentialing databases with current and accurate provider information. This includes ensuring timely updates of licensure status, certifications, and insurance credentials.
**4. Collaboration with Healthcare Institutions**: Interface with hospitals, insurance companies, medical groups, and licensing boards to manage the credentialing workflow and ensure that all necessary certifications and licenses are active and up to date.
**5. Verification**:Conduct primary source verification (PSV) for licensure, education, work history, and other qualifications for healthcare providers, ensuring all requirements are met before submission.
**6.Reports and Audits**:Support in generating and reviewing credentialing reports and conducting internal audits to ensure that all documentation is accurate and ready for external audits or accreditation bodies.
**7. Problem Resolution**: Proactively address discrepancies, issues, or delays in the credentialing process, escalating concerns to management when necessary, ensuring mínimal disruption to provider operations.
**Qualifications**:
Education: Bachelor’s degree in Healthcare Administration, Business, or a related field.
Experience: Minimum of 2 years of experience in credentialing, preferably in a healthcare setting.
Technical Expertise: Proficiency with credentialing software (e.g., MDTech, Cactus, Verity) and database management systems.
Compliance Knowledge: Familiarity with industry standards such as NCQA, URAC, JCAHO, and other regulatory bodies.
Skills: Exceptional attention to detail, analytical and organizational skills, with the ability to manage multiple tasks and prioritize effectively.
Pay: ₹10,000.00 - ₹30,000.00 per month
Schedule:
- Rotational shift
- UK shift
Ability to commute/relocate:
- Andheri, Mumbai, Maharashtra: Reliably commute or planning to relocate before starting work (required)
Application Question(s):
- Do you have experience with US Medical Billing?
**Experience**:
- Microsoft Excel: 1 year (required)
- total work: 2 years (required)
- Medical billing: 1 year (required)
Work Location: In person
-
In-Country Representative
4 weeks ago
Mumbai, Maharashtra, India, Maharashtra Zista EdVentures Full timeCompany OverviewZista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
3 weeks ago
Mumbai, India Zista EdVentures Full timeCompany Overview Zista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
3 weeks ago
Mumbai, India Zista EdVentures Full timeCompany Overview Zista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
3 weeks ago
Mumbai, India Zista EdVentures Full timeCompany Overview Zista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
4 weeks ago
Mumbai, India Zista EdVentures Full timeCompany OverviewZista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
2 weeks ago
mumbai, India Zista EdVentures Full timeCompany Overview Zista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
3 weeks ago
Mumbai, India Zista EdVentures Full timeCompany OverviewZista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
3 weeks ago
Mumbai, India Zista EdVentures Full timeCompany OverviewZista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
3 weeks ago
Mumbai, India Zista EdVentures Full timeCompany OverviewZista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
-
In-Country Representative
3 weeks ago
Mumbai, India Zista EdVentures Full timeCompany OverviewZista is a leading provider of tailored recruitment and marketing solutions for universities, higher education institutions, and education service providers seeking to establish or expand their presence in the Indian Subcontinent and the Middle East. We excel in executing strategic initiatives that elevate brand visibility, optimize outreach...
