Hyderabad Telangana IND o Managed Care Contracting Job Type Full-time Description Who We Are nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers ASCs surgical clinics surgical hospitals and anesthesia groups Our tech-enabled solutions allow surgical organizations to streamline their revenue cycle processes reduce administrative burden and improve financial outcomes Join more than 1 100 surgical organizations that trust nimble solutions and its advisors to bring deep insights and actionable intelligence to maximize their revenue cycle Job Summary The Assistant Manager - Provider Credentialing Managed Care Contracting is responsible for managing provider credentialing processes and supporting all aspects of managed care contract administration across Ambulatory Surgery Centers ASCs This role involves contract loading payment variance analysis chargemaster audits and reimbursement analytics to ensure accurate and timely payer setup and optimal revenue realization Key Responsibilities Payment Variance CalculatorsCreate and maintain facility-specific calculators by identifying top commercial payers Update calculators based on commercial rate changes and effective dates Support Payment Posting team with ThoughtSpot reports and contract profile analysis Contract Loading MaintenanceLoad Medicare contracts quarterly and commercial contracts periodically in the Practice Management System PMS Create and update contract profiles including carve-outs exemptions and rate changes Track contract end dates and ensure timely updates based on Medicare fee schedules and payer updates Chargemaster Code-to-Rate AnalysisPerform chargemaster analysis using 12-month billed charges and reports Conduct periodic audits and maintenance of chargemaster data Execute code-to-rate analysis for specific CPT codes Reimbursement Metrics AnalysisAnalyze implant reimbursement and multiple-of-Medicare scenarios based on facility needs Extract and compile metrics from payer contracts and PDFs for internal reporting Contractual Adjustments Workflow TasksReview contract rates in response to operational team queries regarding contractual adjustments not taken Manage daily tasks received through the C3PO workflow tool from departments like coding charges payment posting and AR Contract Loading Tracker CPT MaintenanceMaintain and regularly update the contract loading tracker Ensure accurate CPT code loading in the PMS CredentialingOversee provider credentialing and re-credentialing processes across ASC facilities Ensure timely submission and follow-up with payers for credentialing approvals Maintain accurate credentialing records and documentation Requirements QualificationsBachelor s degree in healthcare administration Business or related field master s preferred 6-10 years of experience in provider credentialing and managed care contracting Strong knowledge of Medicare and commercial payer reimbursement methodologies Proficiency in Practice Management Systems Excel and reporting tools e g ThoughtSpot Excellent analytical organizational and communication skills Preferred QualificationsExperience with ASC operations and revenue cycle workflows Familiarity with CPT HCPCS coding chargemaster structures and payer contract terms Ability to manage multiple priorities and meet deadlines in a dynamic setting LogisticsLocation Hyderabad Department Managed Care Contracting Reports To Senior Vice President Employment Type Full-Time Shift timings 6PM to 3AM IST night shift