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Contract and Credentialing Specialist

Location: Pittsburgh, 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.

Position Summary: 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.  .   

Essential 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 thte plan(s).  
  • 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 – point of contact for all future credentialing communication
  • Maintain internal database for all Contracts, Skilled Nursing Agreements, Hospital Master Facility Agreements, State Licensure and Business Associate Agreements
  • Creation of Hospital and/or SNF Payment Agreements as requested by field and/or hospital
  • 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
  • Organize, track and report on Performance Improvement Activities and Initiatives
  • 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

Supervisory Responsibilities: None.

Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skills and abilities required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.

Educations and/or Experience:

  • 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 MS Office Suite

Language Skills : Ability to read and comprehend simple instructions, short correspondence, and memos.  Ability to write simple correspondence.  Ability to effectively present information in one-on-one,  small and large group situations to customers, clients, and other employees of the organization.

Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.

Computer Skills: To perform this job successfully, an individual should be proficient in Microsoft Office Suite.

Physical Demands: 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 frequently required to sit, walk, talk and hear.  Employee may occasionally be required to lift and carry up to 25 pounds.

Work Environment: 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.

ZOLL is an Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.