Direct Employer
esponsible for facility credentialing function for Physicians, Hospital, Pharmacy, Medical Diagnostic Service Providers in accordance with internal policies and government regulatory requirements for Healthcare providers. Core Responsibilities: Perform credentialing and re-credentialing activities of all providers and practitioners, Pharmacy, Hospital, HMO, Medical Diagnostic Centres; involves detailed review of documents and data in compliance with regulatory standards (NDPR and Healthcare regulatory agencies-MDCN, MLSCN,PCN,RRBN,MRTB) Complete and process credentialing applications for verification, approve or follow up or rejection. Work with Operational leadership, managers, and IT team in maintaining coverage schedule and ensuring patients and providers use the system at all times. 24/7 system check for new registrations and approval and verification and checking with regulators for approval. Work closely with providers, hospital medical staff offices, pharmacy, Medical Laboratories, Imaging centres, Diagnostic centres, HMO, Partners and internal staff for onboarding processing and use of the services. Ensure all providers are paid timely and ensure patients use the system for teleconsultations and support deployment of the telemedicine equipment. Follow up on all open items. Provide primary source verification/ongoing review of credentialing files. Present credentialing files to Compliance for review and approval; meet all Regulatory requirements. Perform physical and real time video verification for each provider before approval Effectively support other system administrative assistants, especially for high priority meetings, deadlines and deliverables Demonstrate a sense of urgency, initiative, responsiveness, and attention to detail. Routinely handle internal and external inquiries by screening calls, answering questions, and redirecting to appropriate personnel. Special projects and other duties as assigned