Credentialing and Provider Enrollment Specialist
- Location
- Hiring in
- United States
- Pay
- Unavailable
This is a remote position.
Job Summary
RCM Staff BPO is hiring a part-time Credentialing and Provider Enrollment Specialist to support an orthopedic spine surgery practice based in Georgia.The specialist will manage provider and group enrollment with Medicare, Medicaid, and commercial payers, maintain CAQH profiles, and track every application through approval. This role requires hands-on Medicare enrollment experience through PECOS, strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.Key Responsibilities
- Prepare, submit, and track Medicare enrollment applications through PECOS, including individual, group, and reassignment of benefits applications
- Respond to Medicare Administrative Contractor development requests and correct application issues to keep enrollments moving
- Complete Medicaid and commercial payer credentialing and contracting applications for new and existing practice locations
- Create, update, and re-attest CAQH ProView profiles using provider-authorized access
- Maintain NPI, license, DEA, board certification, malpractice, and hospital privilege records with expiration dates
- Follow up with payers by phone, email, and portal until each application is approved and effective dates are confirmed
- Track application status, reference numbers, and effective dates in the practice's credentialing tracker
- Notify the practice of approvals, denials, missing documents, and upcoming revalidation or re-credentialing deadlines
- Process demographic updates such as new locations, address changes, and added services with each payer
- Protect patient and provider information and follow HIPAA requirements
- At least 2 years of experience with U.S. healthcare credentialing and provider enrollment
- Hands-on experience submitting and managing Medicare applications in PECOS, including CMS-855 enrollment and reassignment
- Familiarity with commercial insurance and government health plans
- Experience with CAQH ProView, NPPES, and payer enrollment portals
- Strong written and spoken English
- Excellent attention to detail and follow-up skills
- Ability to work independently and manage multiple applications and deadlines
- Reliable internet connection and a suitable remote workspace
Preferred Qualifications
- Experience credentialing surgeons or specialty practices such as orthopedics, spine, or pain management
- Experience enrolling a newly formed group practice, including multiple locations
- Familiarity with Georgia Medicaid and Georgia commercial insurance plans
- Experience with hospital and ambulatory surgery center privileging
- Part-time position
- Must be available during Eastern Time business hours
- Final schedule will be determined based on practice needs
Work Arrangement
- Remote
- Philippines-based applicants preferred
About RCM Staff LLC
RCM Staff LLC, operating as RCM Staff BPO, is a business process outsourcing company specializing in healthcare revenue cycle management and front office operations.
They provide remote staffing solutions for U.S. medical practices, handling patient intake, insurance verification, benefits determination, referral management, and scheduling functions.
The company supports specialty practices, including rheumatology, by providing experienced coordinators who manage the patient onboarding process and work alongside in-office teams.
RCM Staff BPO focuses on delivering efficient, HIPAA-compliant front desk support that streamlines patient scheduling and insurance coordination for healthcare providers.
Healthcare Business Process Outsourcing
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