Job Description
Role
•
• Coordinates work flow and tactical implementation of various activities related to maintaining facility, provider network and contracting initiatives.
• Participates in projects designed to improve all levels of network performance, which may include multiple lines of business.
• Primary duties may include, but are not limited to: May oversee the day to day training, guidance and management of department activities and facilitates resolution of problems and issues.
• Analyzes and coordinates strategies, policies and programs to ensure accurate administration of facility provider contracts across multiple lines of business and multiple platforms.
• Creates tools to assist contract implementation and administration.
• Interfaces with providers on contractual obligations, education, and provider operations manual updates. Coordinates and acts as a business partner on projects that ensures accurate facility and provider reimbursement policy and procedures, such as pricing, POC, OHAS HMO AND OHAS II, complaints and appeals etc.
Claims_Processing
•
• Coordinates work flow and tactical implementation of various activities related to maintaining facility, provider network and contracting initiatives.
• Participates in projects designed to improve all levels of network performance, which may include multiple lines of business.
• Primary duties may include, but are not limited to: May oversee the day to day training, guidance and management of department activities and facilitates resolution of problems and issues.
• Analyzes and coordinates strategies, policies and programs to ensure accurate administration of facility provider contracts across multiple lines of business and multiple platforms.
• Creates tools to assist contract implementation and administration.
• Interfaces with providers on contractual obligations, education, and provider operations manual updates. Coordinates and acts as a business partner on projects that ensures accurate facility and provider reimbursement policy and procedures, such as pricing, POC, OHAS HMO AND OHAS II, complaints and appeals etc.
Claims_Processing
💡 Quick Summary
Seeking a career-building opportunity? The Assistant Manager position is now open for candidates interested in the Helper Jobs sector. This role in Mumbai offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Helper Jobs is a plus.