Northeast Credentialing Specialist (Remote) Job at Rezolut, Fullerton, CA

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  • Rezolut
  • Fullerton, CA

Job Description

Job Description

Job Description

Rezolut Imaging is seeking a Credentialing Specialist to join our team!

Who is Rezolut?

Rezolut is a national emerging platform of diagnostic medical imaging services. With focus on four key platforms, our vision is to provide topnotch patient care partnered with innovative technology — to achieve better health outcomes.  

Position Summary

The Northeast Credentialing Specialist will be responsible for supporting national payor and facility credentialing support growing Radiology Services Organization.

Note: This role will be specifically supporting New York, New Jersey, and Pennsylvania credentialing. As a member of the Payor Contracting and Credentialing team this teammate will be a key contributor to company’s objectives by improving our credentialing execution, management and other special projects.The ideal candidate will reside in the New York or California area.

Position Duties and Responsibilities

  • Own, track, and manage Medicare, Medicaid, and other third-party public and private payor, facility and provider enrollment and credentialing.
  • Primary point of contact inside and outside of the organization for related questions and requests.
  • Develop and maintain relationships with new and existing third-party payors credentialing counterparts
  • Knowledgeable of credentialing process and best practices as well as staying on top of new trends and respective company impacts.
  • Track, organize and provide timely update for all credentialing applications.
  • Problem solves, troubleshoot and research credentialing issues independently.
  • Partner and support Payor Contracting and Revenue Cycle Management (RCM) departments, patients, etc. with related ad-hoc reporting and analyses as needed.
  • Creation and updating of guides, Standard Operating Procedures (SOPs), announcements, and other documentation for the department and RCM customers.
  • Independently run with ad-hoc projects and other duties as assigned.

Required & Desired Professional Skills and Experience

  • Required: at least 2 years of experience in the field or in a related area
  • Required: experience with New York Medicare & Medicaid, NYWC and other 3rd party New York payors
  • Competent in Excel, Powerpoint, Smartsheet, OneNote
  • Nice to have – experience with Credential Stream and Availity
  • Prior Healthcare, RCM, Credentialing, or Medical Billing experience is required
  • Working knowledge and understanding of Medicare physician reimbursement methodologies is required
  • Work collaboratively across multiple functions (Credentialing, RCM, and Payor Contracting)
  • Highly motivated self-starter who is an excellent team player
  • Outstanding organizational and communication (both verbal and written) skills
  • Ability to innovate in a fast-growing work environment and comfortable dealing with ambiguity
  • Ability to work independently in a complex and often fast-paced environment. A self-motivated and resourceful attitude, taking intellectual ownership of work and projects. Proactively identifying issues, prepared to address concerns/questions and make recommendations.

What We Offer

  • Immediately accrue PTO as you work! (Full Time)
  • 6 Observed Holidays
  • Medical, Dental, Vision, Life and other voluntary insurances for full-time employees
  • 401(k) Retirement plan 
  • Employee Assistance Program

Location: Remote

Job Tags

Full time, Immediate start,

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