Equal Opportunity Employer/Disability/Veterans
This a part-time (24 hours a week), hybrid position reporting to the Norwood, MA office
Reliable Respiratory is a Durable Medical Equipment (DME) company that provides the highest quality level of service for patients in need of respiratory, diabetes, urology, and maternity support. Equipment provided includes, CPAPs, BiPAPs, AutoPAPs, nebulizers, oxygen equipment, ventilators, CGM devices, insulin pumps, and breast pumps.
Each patient is treated with professionalism, understanding, and attentive service. We care about our customers, work closely with the medical community, and have highly skilled staff ready to assist customers in receiving the best care possible
The Medical Contract and Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing requirements.
Duties and Responsibilities
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Manage the contracting process with insurance companies, including commercial and government payors (Medicare, Medicaid), ensuring adherence to all regulatory requirements.
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Coordinate credentialing activities for DME providers, ensuring compliance with insurance company standards and regulations
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Maintain accurate databases of contracted providers and DME products, ensuring timely updates and compliance with insurance company requirements
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Monitor and track contract renewals and expirations, proactively managing timelines and requirements
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Collaborate with internal teams to address contracting and credentialing issues, providing support and guidance as needed
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Work closely with billing staff to identify and resolve any denials or authorization issues related to provider credentialing
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Apply for and renew all provider licenses; Professional, Controlled Substance, etc.
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Maintain accurate database of provider licenses (expiration dates, locations, posting requirements)
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Other duties as assigned
Required Qualifications
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18 years of age or older
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Must be eligible to work in the United States and not require work authorization from us now or in the future
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Associate’s degree required, Bachelor’s degree preferred
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At least 2 years of experience in contracting and credentialing with insurance companies, particularly in the DME sector
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Strong knowledge of insurance company standards and regulations related to DME contracting and credentialing
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Excellent organizational skills with meticulous attention to detail, ensuring accuracy and compliance in all documentation and processes
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Other duties as assigned
Required Skills
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Effective and professional verbal and written communication abilities
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Professional computer experience (especially Microsoft Office Suite)
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Ability to work independently to investigate and make decisions
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Ability to work in collaboration with others
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Ability to comply with guidelines both internal and industry-imposed
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Strong attention to detail
Competencies
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Analytical skills
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Attention to detail
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Communication
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Decision making
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Dependability
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Initiative
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Job knowledge
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Organizational skills
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Problem solving
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Teamwork
Work Environment & 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.
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While performing the duties of this job, the employee is regularly required to communicate and convey information with the appropriate parties. The job requires assuming a stationary position for long periods of time
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This role routinely uses standard office equipment such as computers, phones, and printers/scanners
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.
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This job operates in a professional office environment
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The noise level in the work environment is usually moderate to loud if employee wished to be in office
Direct Reports – None at this time
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Reliable Respiratory, INC participates in E-Verify. E-Verify is a web-based system that allows an employer to determine an employee's eligibility to work in the US using information reported on an employee's Form I-9. The E-Verify system confirms eligibility with both the Social Security Administration (SSA) and Department of Homeland Security (DHS). For more information, please go to the USCIS E-Verify website.