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Credentialing Specialist

2 months ago

Orlando, Florida, United States Rotech Inc Full time
About Rotech

Rotech Healthcare Inc. is a national leader in providing medical equipment and services to patients across the country. Our mission is to empower patients to manage their health and treatment at home, while providing high-quality medical products and services through our extensive network of locations.

Job Summary

We are seeking a highly skilled Credentialing Specialist to join our team. In this role, you will be responsible for ensuring the complete credentialing process is executed in accordance with payer credentialing policies and procedures. This includes reviewing contract language, provider manuals, and requirements to ensure Rotech compliance and contract performance standards are met.

Key Responsibilities
  • Administer contracts, including reviewing payer contract language, policies, and procedures
  • Analyze monthly trend reports to identify areas for improvement
  • Assign and update contract classifications for managed care and government reporting purposes
  • Assist with projects related to billing rules, HCPCS, and ICD-9 codes
  • Communicate with various departments regarding contract changes and updates
  • Complete payer credentialing and re-credentialing applications
  • Conduct conference calls with payors as required
  • Research and apply internal company rules and policies to contract requirements
  • Update contracts with Medicare and Medicaid requirements
  • Perform other duties as assigned
Requirements
  • High school diploma or GED equivalent
  • Five years of experience in the medical industry, with knowledge of HCPCS, CPT, and ICD-9 codes
  • Ability to identify and resolve potential financial risk items
  • Effective communication and problem-solving skills
  • Ability to work independently and as part of a team
Benefits
  • 401k plan
  • Medical, dental, and vision insurance
  • Life insurance and disability benefits
  • Generous paid time off and holidays
  • Employee discount program
  • Employee recognition program
  • Bonus and incentive opportunities