Senior Manager/AGM - Credentialing
ecare India Pvt Ltd
- Location
- Chennai, Tamil Nadu, India
- Job type
- Full-time
Required skills
- communication skills
- compliance
About the role
ecare India Pvt Ltd
Website:
ecareindia.com
Job details:
Skills Required:
- Effective communication skills, both verbal and written.
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
- Minimum 15+ years of Experience in Provider Credentialing (Federal & Commercial)/Provider Enrollment
- Strong understanding of healthcare regulations and payer requirements.
- Minimum 7 years of Experience in Team Handling
- Excellent Interpersonal & Client coordination skills
- Proven leadership skills
- Critical thinking and problem-solving skills
Job Summary:
- 15+ years of experience handling in multiple projects in Provider credentialing and enrollment
- Willingness to work in Mid-shift and to Work From Office
- Serve as the liaison with third-party payors, ensuring accurate provider data and up-to-date credentialing status.
- Monitor license and certification expirations, proactively facilitating renewals to avoid service disruption.
- Implement, update, and maintain internal credentialing policies, protocols, and compliance procedures.
- Maintain accurate and timely reports on credentialing status for all providers.
- Ensure proper enrollment in Medicare, Medicaid, CAQH, PECOS, and commercial payor portals.
- Assist in audits, prepare documentation for regulatory and accreditation bodies, and ensure adherence to the requirements.
- Drive continuous improvement of credentialing processes and resolve complex compliance issues.
- Support negotiation and documentation for new insurance contracts or provider affiliations
- Excellent organizational skills with the ability to manage multiple tasks and priorities.
- Maintain process compliance as per client requirements and applicable state laws.
- Project planning and Execution
- Client Management
- Hiring, training and guiding teams
- Ensure project delivery is on time, as per scope and within the fixed TAT
- Manage coordination between projects to ensure smooth delivery
- Evaluating project performance regularly and identify areas for improvement
- Create and maintain detailed project documentation
- Estimate resource requirement, acquire it effectively and manage efficiently
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