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Job Description

Credentialing Executive will be responsible to:

  • Review the approval and termination of professional provider contracts as they relate to the credentialing process.
  • Ensure the accurate and timely information for the purposes of re-credentialing, data analysis and directory generation as well as recommending changes to the credentialing criteria and processes.
  • Maintain all credentialing and re-credentialing policies and processes to ensure that they are in compliance with and all applicable regulations.
  • Develop and implement departmental policies and procedures that guide and support the provision of services.
  • Interact with all clients to ensure prompt and accurate communication as needed to provide the service expected and to meet the goals of the service.
  • Develop new ideas and/or systems with innovation and creativity.
  • Lead by example and serves as a professional role model.
  • Responsible for the continuous assessment and improvement of the quality of care and services provided.
  • Adhere to all Compliance & Integrity Program rules and requirements
  • Manage all New Client Account Setups, Research and Development activities.
  • Manage VAS (value added services), provider enrollment, claims submission and various other projects.
  • Train and guide team members on new challenges in healthcare industry along with a keeping a close coordination with providers (clients).

Mandatory Requirements:

  • Minimum 2 years of recent credentialing experience is required. 
  • Strong verbal & written communication skills and good in cross functional interactions & coordination.

Job Details

Functional Area:
Total Positions:
1 Post
Job Shift:
Third Shift (Night)
Job Type:
Job Location:
No Preference
Minimum Education:
Career Level:
Experienced Professional
Minimum Experience:
2 Years
Apply Before:
Nov 16, 2020
Posting Date:
Oct 16, 2020
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HQ Analytics Inc

Healthcare / Hospital / Medical · 11-50 employees - Lahore

pHQ Analytics is Lahore Based. We provide medical billing and back office management services in Healthcare system in USA./p

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