Contract and Credentialing Specialist

Location: Remote, PA

Cardiac Management Solutions

The Cardiac Management Solutions division of ZOLL Medical Corporation develops products to protect and manage cardiac patients, including the LifeVest® wearable cardioverter defibrillator (WCD), the ZOLL cardiac monitor, and associated technologies. Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need. To date, the LifeVest WCD has been worn by hundreds of thousands of patients and saved thousands of lives. ZOLL has been Pittsburgh’s Manufacturer of the Year, one of Western PA’s Healthiest Employers, and even one of Pittsburgh’s Coolest Offices. But it’s our unique opportunity to impact people’s lives that makes ZOLL the ideal place to build your career.

Job purpose

The Contract and Credentialing Specialist supports the National Accounts Team and Reimbursement Operations of the company by preparing and credentialing activities such as active State licensure, Medicaid program enrollments, and active Accreditation status as well as sustaining internal databases.     

Duties and responsibilities

  • Research, prepare, submit and track contract applications and keep updated reports of the progress of each contract submission to include credentialing applications, enrollment applications and others as required by the plan(s)  
  • Maintain internal database for all Contracts, Skilled Nursing Agreements, Hospital Master Facility Agreements, Correctional Facilities and State Licensure
  • Creation and internal execution of Hospital and/or SNF Payment Agreements as requested by field and/or hospital
  • Maintain timely Medicaid Program enrollments and re­enrollments as well as State DME license renewals through mail, email, portal reviews or phone calls to state Medicaid Offices – maintain point of contact for all future credentialing communication
  • Maintain and updates the Payer Resource Center and completes data input with respect to all signed contracts in Contracted Payer Database on a timely basis.
  • Create and analyze Payer Data packages for the National Account team along with other   ad hoc reports as requested
  • Responsible for coordination of the Accreditation processes and activities in accordance with ACHC standards in order to maintain an active accreditation status. Recommend revisions to internal policies and procedures to remain in Compliance with ACHC standards
  • Secondary point of contact for all Reimbursement facing site visits
  • Organize, track and report on Performance Improvement Activities and Initiatives as applicable
  • Complete/triage trainings, orientations and attestations as required for payer Compliance
  • Assist in the creation of ad hoc reporting to track and trend payer behavior
  • Other duties as assigned by Management

Qualifications

Qualifications include:

  • Bachelor’s degree in business, finance or related field preferred
  • 3 to 5 years of Reimbursement and or Contracting Experience; Preferably in DME
  • Superior oral and written communication and customer service skill
  • Proficiency in Excel and all MS Office Suite products

Working conditions

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 The noise level in the work environment is usually quiet.

Physical requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Supervisory responsibility

None

AAP/EEO Statement

ZOLL is committed to fostering an inclusive workplace, where unique identities, backgrounds, cultures, perspectives and experiences are respected and valued.

 Equal Opportunity Employer – Disability and Veteran

ZOLL now mandates COVID vaccinations subject to legal exemptions.

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