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Credentialing & Enrollment Team Lead

4 weeks ago

Rawalpindi Cantonment, Pakistan Meds Nexus Private Limited Full time

Job Description

Meds Nexus is looking for candidates on the night shift with experience as Team Lead Credentialing & EDI. The candidate should be enthusiastic and must have proven work experience in performing all New Client Account Setups, Research and Development activities, ensuring that the credentialing requirements for government and commercial payers are met. The candidate will submit and follow up on submitted credentialing requests to all contracted commercial payers and government agencies. Basic IT skills (databases, MS Office, etc.) are preferred.

Job Responsibilities:

  1. 3 to 5 years of experience in credentialing department.
  2. At least 1 year of experience in a Supervisory Role.
  3. Experience in credentialing different specialties with major regular and private payers state-wise.
  4. Review the approval and termination of professional provider contracts as they relate to the credentialing process.
  5. Ensure accurate and timely information for re-credentialing, data analysis, and directory generation, as well as recommending changes to the credentialing criteria and processes.
  6. Maintain all credentialing and re-credentialing policies and processes to ensure compliance with all applicable regulations.
  7. Develop and implement departmental goals and objectives with input from staff members.
  8. Develop and implement departmental policies and procedures that guide and support the provision of services.
  9. Interact with all customers to ensure prompt and accurate communication as needed to provide the service expected and to meet the goals of the service.

Job Rewards and Benefits:

  1. Paid Leaves
  2. HR Bonus
  3. Inflation Bonus
  4. Promotion
  5. Increments
  6. Medical (TBD)
  7. Employee Equity Funds Program (EEFP)
  8. Saturday and Sunday Off
  9. Complementary Food (Dinner) & Tea/Green Tea (Two times)

Job Location: Office # 1st, 5th Floor, Gold Mark Plaza, Asghar Mall Rd, Asghar Mall Scheme, Rawalpindi, Punjab 46000

Job Timing: 05:30 PM To 02:30 AM

Special Note: This job is not for fresh candidates.

Job Types: Contract, Full-time

Contract length: 36 months

Bachelor's (Preferred)

Experience: Credentialing & Enrollment + EDI: 5+ years (Preferred)

Language: Fluent English (Preferred)

Pay: Rs100,000.00 – Rs150,000.00 per month

Ability to Relocate: Rawalpindi: Relocate before starting work (Required)

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