Samuel A R Misra

About Samuel A R Misra

Seasoned People Manager with a diverse background in BFSI, ITES, and Healthcare, along…

Experience

1. Operations Manager

   GHX India

   Jun 2024 — Present · Hyderabad, IN

   Credentialing Management & Customer Service (Phone-Chat-Email)- Oversee the credentialing and re-credentialing processes for healthcare providers and vendors, ensuring timely verification of qualifications and compliance with regulations- Maintain comprehensive records of credentialing information.Team Leadership- Supervise credentialing specialists, providing guidance and support- Conduct regular team meetings and facilitate ongoing training.Regulatory Compliance- Ensure compliance with local, state, and federal regulations (e.g, NCQA, URAC, CMS)- Prepare for audits and maintain policies for accrediting bodies and payer requirements.Process Improvement- Identify and implement enhancements to increase efficiency in credentialing workflows- Use technology to streamline processes and monitor key performance indicators (KPIs).Collaboration- Work with HR, Compliance, Legal, and Operations to maintain accurate credentialing information- Provide guidance to other teams on credentialing processes.Reporting & Documentation- Generate and track credentialing reports and maintain records for audits- Prepare reports for senior management on key metrics and risks.Issue Resolution- Address and resolve credentialing-related issues, acting as the primary contact for inquiries and concerns.

Education

• Siliguri College of Commerce

  Bachelor’s Degree, Business/Commerce, General

  2000 — 2003

• Siliguri College of Commerce

  High School, Accounting and Commerce

  1998 — 2000

• Lincolns High School

  ICSE

  1993 — 1998

• SILIGURI COLLEGE OF COMMERCE, DARJEELING

  Bachelor of Commerce - BCom, Business/Commerce, General