Credentialing Specialist

Job Details - Job Location: TX Remote - Houston, TX - Position Type: Full Time - Salary Range: Undisclosed Job Summary Capitol Imaging Services, we’re a leading provider of diagnostic imaging services committed to delivering high-quality patient care through innovation and a compassionate approach. Our high-quality radiology services include—MRI, CT, PET/CT, Nuclear Medicine, ultrasound, X-ray, and mammography. We are currently operating 60 facilities across six states in the Gulf Coast region. The Credentialing & Payor Enrollment Specialist/Denial Management Specialist is responsible for ensuring our facility and healthcare providers at our outpatient facilities are properly credentialed and enrolled with government and commercial insurance payors. This fully remote role supports provider onboarding, maintains regulatory and payor compliance, and plays a critical role in ensuring uninterrupted patient access to care and timely reimbursement. The successful candidate will be accountable for reducing insurance denials, minimizing revenue write-offs, improving net reimbursement, and preventing future reimbursement failures through root-cause analysis and durable process improvement.

Key Responsibilities

Reimbursement Strategy and Denial Prevention - Take charge of the overall strategy to cut down on insurance denials and write-offs from payers - Identify, analyze, and prioritize root causes of denials and non-payment across modalities, payers, and sites - Design and implement systematic solutions to prevent recurrence - Identify denial trends and turn them into actionable operational SOP’s - Conduct follow up with payers and insurance companies to resolve claim denials and payment