Rotech Healthcare Inc.
About Rotech
Join a Leader in Home Healthcare
At Rotech Healthcare Inc., we’re more than a medical equipment provider—we’re a trusted partner in patient care. As a national leader inventilators, oxygen therapy, sleep apnea treatment, wound care, diabetic solutions, and other home medical equipment, we empower patients to manage their health from the comfort of home.
With hundreds of locations across 45 states, our team delivers high-quality products, exceptional service, and compassionate support that helps patients live more comfortably, independently, and actively. Whether you're a clinician, technician, or healthcare administrator, your work at Rotech directly improves lives.
Explore more about our mission and services at Rotech.com.
Overview and Responsibilities Job Summary We are seeking a dedicated
Credentialing Specialist
to join our team. In this position, you are responsible for the complete credentialing process as defined by payer credentialing policies and procedures including provider manuals, contract language and requirements to ensure Rotech compliance and contract performance standards are met for all Rotech Locations. Position responsibilities also include re-credentialing, submission of COIs and licensure expirations, LANs, provider acquisition reporting and ensuring Rotech’s compliancy with the No Surprise Act.
Work From Home after successful completion of IN OFFICE TRAINING and are meeting expectations with management approval
Essential Job Duties and Responsibilities (Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. 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.)
Administration of contracts includes but not limited to a complete review of payer contract language, policies and procedures, provider manuals, billing rules and guidelines
Analyzes monthly trend reports (Held Item, Adjustment Analysis) to identify additional research and/or updates required to Contract/ Item Master
Assigns and updates necessary contract classifications for Managed Care/Government Reporting purposes
Assist with projects at BCC when access to older billing rules, HCPCs, ICD9, etc. is required to process claims in arrears (monitor window of claims processing to ensure no inaccurate billing occurs during project time frame)
Assists in creating and maintaining Rotech’s Supplier Diversity Database including yearly mailing to all Rotech vendors
Communicates with Purchasing on appropriate base contract pricing- Contract
Communicates with the Billing Center, Central Intake, Sleep Central and Locations regarding contract changes and/or updates including distribution of reference guides as required
Completes payer credentialing and re-credentialing applications via hard copy, email, fax or online based on payer specifications
Conducts conference calls with payors as required
Conducts Contact implementations with appropriate departments as well as payer in-services as required
Conducts/leads calls with payers regarding changes and/or updates to payer rules, processes, guidelines, pricing methodologies and credentialing practices
Creates and maintains job aids and training materials as it relates to contract and credentialing functions and systems used within CAD
Creates FOIA requests as appropriate
Files yearly government reports such as Subcontracting report, CCR registration, Vets-100
Maintains Contract Quick Reference Guides on the Rotech Home Page
Maintains current Location database spreadsheet and COIs
Maintains database of contracts within shared drive, e-Intake and Contract Logix
Maintains database of credentialing/re-credentialing within Laser Fiche and shared drive
Maintains Location Dashboard information so assigned contracts appear on appropriately contracted locations
Maintains monthly LANs updates and appropriate payer notification
Maintains pricing and other updates within the online ordering system as required
Maintains timely filing requirements outlined in Contracts to ensure claims drop as required by Contracted Payers into the timely filing cue within the billing center
Maintenance and administration of all Contracts Rotech provides service for including but not limited to Managed Care, Government, Hospice, Skilled Nursing, Non-Participating or Out of Network, Professional Service Agreements and Patient Pay Contracts
Monitors the release of solicitations daily and maintains a list of active solicitations within company database
Obtains and updates all Medicare and Medicare Non-Assigned Contracts as new HCPCS, Pricing, Modifiers, Certification requirements are published and available (researching websites, payor payment boards, government websites, etc.)
Obtains, researches, and updates each State’s Medicaid Contract, HCPCS, Pricing, Modifiers and Certification requirements as published on various state websites, government payment boards, etc.
Performs maintenance and administration of HCPCS and ICD-9 codes as updated, changed or published by Medicare to ensure appropriate HCPCS and ICD9 are available for predetermined effective date and claims processing
Receives, researches, and validates payer claims addresses and designates applicable billing requirements that will print on all Rotech paper claim forms. Maintains all updates or changes to these requirements as submitted by locations, BCC’s, and/or payers
Research and applies internal company rules and policies to all items set-up on contracts, Sales Commission Points, Assignment of Benefits Requirements, Coverage type for Rent to Cap items, product category, product class inventory track able items, eintake viewable items, eintake product kit set ups and manufacturer requirements
Research of competitor information
Researches and verifies contract requirements through various sources (billing/payment history, payor provider support, etc.) when there are no contracted requirements on file
Updates all Private Insurance Contracts that are on schedule with Medicare HCPCS, Pricing, Modifier and Certification updates (as provided on payor profile, through contracting department, or payor payment boards/websites, etc.)
Performs other duties as assigned
Qualifications Employment is contingent on
Background check (company-wide). Results will not be used automatically to disqualify individuals. Instead, the Company will conduct an individualized assessment that considers the duties of the position, the nature and timing of the offense, and any evidence of rehabilitation, in accordance with applicable laws.
Drug screen (when applicable for the position)
Compliance with healthcare facility credentialing process (when applicable for the position)
Valid driver’s license in state of residence with a clean driving record (when applicable for the position)
Required Education and/or Experience
High school diploma or GED equivalent, required
Knowledge of Healthcare Contract Language and the ability to read and interpret Contract/Credentialing requirements and guidelines
Five years directly related experience in the medical industry working with HCPCS, CPT and ICD-9 Codes
Preferred Education and/or Experience
Paralegal Certificate, preferred
Bachelor’s Degree or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts, preferred
Lead/Supervisory experience
Skills and Competencies
Ability to identify and resolve potential financial risk items/situations
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
Ability to think critically and analytically
Effectively communicate in English; both oral and written
Interpret a variety of communications (verbal, non-verbal, written, listening and visual)
Knowledge of Industry Contracts and medical billing
Maintain confidentiality, discretion and caution when handling sensitive information
Multi-task along with attention to detail
Self-motivation, organized, time-management and deductive problem solving skills
Work independently and as part of a team
Machines, Equipment and Technical Abilities
Email transmission and communication
Internet navigation and research
Microsoft applications; Outlook, Word and Excel
Innovative Medical Billing System (IMBS) preferred
Office equipment; fax machine, copier, printer, phone and computer and/or tablet
Physical Demands
Lift and carry office equipment at times
Requires sitting, walking, standing, talking and listening
Requires close vision to small print on computer and/or tablet and paperwork
Benefits
Generous paid time Off and paid holidays
Overtime pay for non-exempt hourly positions based on business needs
Commission for Account Executives
Fixed and variable rate car reimbursement for Area Managers and Account Executives
Employee discount program
Employee recognition program
Bonus and incentive opportunities
Mileage reimbursement (when applicable for the position)
Telephone reimbursement (when applicable for the position)
EAP
401k, HSA and FSA/Dependent Care FSA
Medical, Prescription, Dental and Vision
Life Insurance, Disability, Accidental death, Identity protection and Legal services
Meru Health Mental health and Mercer SmartConnect Medicare programs
Livongo Diabetes and High Blood Pressure programs
Healthcare Bluebook and RX Savings solutions programs
HEPB and TB vaccinations
Make the Right Move and Submit your Resume Today!
The hiring manager reviews resumes and contacts applicants that have related experience to the applied position. To view the status of a position that you submitted your profile to, Sign into your account. All positions are posted for a min of 5 days and positions are opened until filled with a qualified applicant, generally no greater than 200 days. We appreciate your interest in Rotech Healthcare Inc.
Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities.
Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, gender identity, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees.
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At Rotech Healthcare Inc., we’re more than a medical equipment provider—we’re a trusted partner in patient care. As a national leader inventilators, oxygen therapy, sleep apnea treatment, wound care, diabetic solutions, and other home medical equipment, we empower patients to manage their health from the comfort of home.
With hundreds of locations across 45 states, our team delivers high-quality products, exceptional service, and compassionate support that helps patients live more comfortably, independently, and actively. Whether you're a clinician, technician, or healthcare administrator, your work at Rotech directly improves lives.
Explore more about our mission and services at Rotech.com.
Overview and Responsibilities Job Summary We are seeking a dedicated
Credentialing Specialist
to join our team. In this position, you are responsible for the complete credentialing process as defined by payer credentialing policies and procedures including provider manuals, contract language and requirements to ensure Rotech compliance and contract performance standards are met for all Rotech Locations. Position responsibilities also include re-credentialing, submission of COIs and licensure expirations, LANs, provider acquisition reporting and ensuring Rotech’s compliancy with the No Surprise Act.
Work From Home after successful completion of IN OFFICE TRAINING and are meeting expectations with management approval
Essential Job Duties and Responsibilities (Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. 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.)
Administration of contracts includes but not limited to a complete review of payer contract language, policies and procedures, provider manuals, billing rules and guidelines
Analyzes monthly trend reports (Held Item, Adjustment Analysis) to identify additional research and/or updates required to Contract/ Item Master
Assigns and updates necessary contract classifications for Managed Care/Government Reporting purposes
Assist with projects at BCC when access to older billing rules, HCPCs, ICD9, etc. is required to process claims in arrears (monitor window of claims processing to ensure no inaccurate billing occurs during project time frame)
Assists in creating and maintaining Rotech’s Supplier Diversity Database including yearly mailing to all Rotech vendors
Communicates with Purchasing on appropriate base contract pricing- Contract
Communicates with the Billing Center, Central Intake, Sleep Central and Locations regarding contract changes and/or updates including distribution of reference guides as required
Completes payer credentialing and re-credentialing applications via hard copy, email, fax or online based on payer specifications
Conducts conference calls with payors as required
Conducts Contact implementations with appropriate departments as well as payer in-services as required
Conducts/leads calls with payers regarding changes and/or updates to payer rules, processes, guidelines, pricing methodologies and credentialing practices
Creates and maintains job aids and training materials as it relates to contract and credentialing functions and systems used within CAD
Creates FOIA requests as appropriate
Files yearly government reports such as Subcontracting report, CCR registration, Vets-100
Maintains Contract Quick Reference Guides on the Rotech Home Page
Maintains current Location database spreadsheet and COIs
Maintains database of contracts within shared drive, e-Intake and Contract Logix
Maintains database of credentialing/re-credentialing within Laser Fiche and shared drive
Maintains Location Dashboard information so assigned contracts appear on appropriately contracted locations
Maintains monthly LANs updates and appropriate payer notification
Maintains pricing and other updates within the online ordering system as required
Maintains timely filing requirements outlined in Contracts to ensure claims drop as required by Contracted Payers into the timely filing cue within the billing center
Maintenance and administration of all Contracts Rotech provides service for including but not limited to Managed Care, Government, Hospice, Skilled Nursing, Non-Participating or Out of Network, Professional Service Agreements and Patient Pay Contracts
Monitors the release of solicitations daily and maintains a list of active solicitations within company database
Obtains and updates all Medicare and Medicare Non-Assigned Contracts as new HCPCS, Pricing, Modifiers, Certification requirements are published and available (researching websites, payor payment boards, government websites, etc.)
Obtains, researches, and updates each State’s Medicaid Contract, HCPCS, Pricing, Modifiers and Certification requirements as published on various state websites, government payment boards, etc.
Performs maintenance and administration of HCPCS and ICD-9 codes as updated, changed or published by Medicare to ensure appropriate HCPCS and ICD9 are available for predetermined effective date and claims processing
Receives, researches, and validates payer claims addresses and designates applicable billing requirements that will print on all Rotech paper claim forms. Maintains all updates or changes to these requirements as submitted by locations, BCC’s, and/or payers
Research and applies internal company rules and policies to all items set-up on contracts, Sales Commission Points, Assignment of Benefits Requirements, Coverage type for Rent to Cap items, product category, product class inventory track able items, eintake viewable items, eintake product kit set ups and manufacturer requirements
Research of competitor information
Researches and verifies contract requirements through various sources (billing/payment history, payor provider support, etc.) when there are no contracted requirements on file
Updates all Private Insurance Contracts that are on schedule with Medicare HCPCS, Pricing, Modifier and Certification updates (as provided on payor profile, through contracting department, or payor payment boards/websites, etc.)
Performs other duties as assigned
Qualifications Employment is contingent on
Background check (company-wide). Results will not be used automatically to disqualify individuals. Instead, the Company will conduct an individualized assessment that considers the duties of the position, the nature and timing of the offense, and any evidence of rehabilitation, in accordance with applicable laws.
Drug screen (when applicable for the position)
Compliance with healthcare facility credentialing process (when applicable for the position)
Valid driver’s license in state of residence with a clean driving record (when applicable for the position)
Required Education and/or Experience
High school diploma or GED equivalent, required
Knowledge of Healthcare Contract Language and the ability to read and interpret Contract/Credentialing requirements and guidelines
Five years directly related experience in the medical industry working with HCPCS, CPT and ICD-9 Codes
Preferred Education and/or Experience
Paralegal Certificate, preferred
Bachelor’s Degree or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts, preferred
Lead/Supervisory experience
Skills and Competencies
Ability to identify and resolve potential financial risk items/situations
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
Ability to think critically and analytically
Effectively communicate in English; both oral and written
Interpret a variety of communications (verbal, non-verbal, written, listening and visual)
Knowledge of Industry Contracts and medical billing
Maintain confidentiality, discretion and caution when handling sensitive information
Multi-task along with attention to detail
Self-motivation, organized, time-management and deductive problem solving skills
Work independently and as part of a team
Machines, Equipment and Technical Abilities
Email transmission and communication
Internet navigation and research
Microsoft applications; Outlook, Word and Excel
Innovative Medical Billing System (IMBS) preferred
Office equipment; fax machine, copier, printer, phone and computer and/or tablet
Physical Demands
Lift and carry office equipment at times
Requires sitting, walking, standing, talking and listening
Requires close vision to small print on computer and/or tablet and paperwork
Benefits
Generous paid time Off and paid holidays
Overtime pay for non-exempt hourly positions based on business needs
Commission for Account Executives
Fixed and variable rate car reimbursement for Area Managers and Account Executives
Employee discount program
Employee recognition program
Bonus and incentive opportunities
Mileage reimbursement (when applicable for the position)
Telephone reimbursement (when applicable for the position)
EAP
401k, HSA and FSA/Dependent Care FSA
Medical, Prescription, Dental and Vision
Life Insurance, Disability, Accidental death, Identity protection and Legal services
Meru Health Mental health and Mercer SmartConnect Medicare programs
Livongo Diabetes and High Blood Pressure programs
Healthcare Bluebook and RX Savings solutions programs
HEPB and TB vaccinations
Make the Right Move and Submit your Resume Today!
The hiring manager reviews resumes and contacts applicants that have related experience to the applied position. To view the status of a position that you submitted your profile to, Sign into your account. All positions are posted for a min of 5 days and positions are opened until filled with a qualified applicant, generally no greater than 200 days. We appreciate your interest in Rotech Healthcare Inc.
Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities.
Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, gender identity, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees.
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