Browse
···
Log in / Register
Job Summary: Professional to support administrative and operational credentialing processes for healthcare service providers, ensuring compliance and facilitating beneficiaries' access. Key Highlights: 1. Support in analyzing documents and contracts for credentialing 2. Assistance in adding, updating, and removing providers in the system 3. Ensuring compliance with ANS regulations and requirements * Responsible for supporting administrative and operational processes related to credentialing healthcare service providers (e.g., physicians, clinics, hospitals, laboratories) at a health insurance operator. The role ensures that the credentialed network complies with the operator’s standards and regulations, facilitating beneficiaries’ access to healthcare services. **Responsibilities and Duties** * Support the analysis of documents and contracts for credentialing new healthcare service providers. * Assist in the process of adding, updating, and removing providers in the operator’s system, ensuring accurate data entry. * Conduct initial contact with healthcare service providers (clinics, hospitals, laboratories) to collect documentation required for credentialing. * Verify documentation submitted by healthcare service providers, ensuring compliance with legal and regulatory requirements (ANS). * Organize and maintain up-to-date records of credentialed providers, including information such as specialties, appointment hours, and location. * Assist in issuing and sending contracts and enrollment agreements to new providers. * Monitor and ensure receipt of signed contracts, maintaining control over deadlines and pending documentation. * Provide support in resolving issues and clarifying doubts raised by providers regarding the credentialing process, contractual adjustments, and deadlines. * Assist in preparing periodic reports on credentialing status and potential pending items. * Collaborate with the credentialing team and other internal departments to maintain the credentialed network. Ensure providers align with policies and requirements set forth by the National Supplementary Health Agency (ANS). * **Requirements and Qualifications** * Prior experience in administrative roles, preferably within health insurance operators or healthcare service providers. * Basic knowledge of ANS regulations related to credentialing and provider networks. * Familiarity with tools and systems for managing healthcare providers. * Strong verbal and written communication skills. * Organizational skills, attention to detail, and ability to work under deadlines. Ability to work collaboratively and interact courteously and effectively with providers. * **Additional Information** **Benefits:** Transportation Allowance or Fuel Voucher Attendance Card Meal Voucher or Food Allowance Health and Dental Plan – employee monthly fee waived Annual bonus based on achieved goals GymPass – access to gyms and wellness programs Life Insurance **Working Hours:** 08:00–12:00, 13:00–17:48, Monday to Friday We are a strong, experienced group driven by health. The DC Group is a platform of independent brands and services connected by a shared purpose: **providing health solutions for people.** **STRENGTH. HEALTH. KNOWLEDGE.** These three pillars guide our actions. It is from this foundation that our companies grow and increasingly distinguish themselves in their respective fields. With ethics, social commitment, and continuous evolution, we continue promoting quality of life, facilitating and simplifying access to healthcare, and innovating in the management of our processes and services. **We are the DC Group, and here, we breathe health.**
