Credentialing and Payer Enrollment Specialist – Part-time

Job not on LinkedIn

🔥 0 minutes ago

🇵🇭 Philippines – Remote

⏱ Part Time

🟢 Junior

🟡 Mid-level

✨ Credentialing Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 15%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

RCM Staff LLC

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2024

🏥 Healthcare

🎯 Recruiter

🤝 B2B

Healthcare • Recruitment • B2B

RCM Staff LLC is a staffing company that provides HIPAA-trained, healthcare-focused medical billers, certified coders, A/R follow-up specialists, and medical virtual assistants based in the Philippines who work directly inside U. S. clients’ existing EHRs, clearinghouses, and payer portals. The company handles recruiting, onboarding, training, and oversight while clients retain operational control; service tiers range from Core (staff augmentation) to Plus (account management and KPIs) and Executive (managed QA and continuity planning). RCM Staff targets medical billing companies, physician practices (solo, group, behavioral health, primary care), and RCM vendors, and emphasizes compliance (BAA available), AAPC-certified leadership, and 18+ years of U. S. revenue cycle experience.

📋 Description

• Prepare and submit initial payer enrollment applications for individual providers and group practices for commercial and government plans • Complete, update, and attest CAQH ProView profiles and keep supporting documents current • Maintain provider records in PECOS and NPPES, including revalidations, reassignments, and demographic changes • Track pending applications and follow up with payer provider relations by phone, portal, and email until effective dates are confirmed • Manage the recredentialing and revalidation calendar to prevent provider lapses with payers • Collect and maintain credentialing documents, including state licenses, DEA registrations, malpractice certificates of insurance, board certifications, W-9s, and CVs, and track expiration dates • Submit roster updates, group additions and terminations, and demographic changes to payers • Document every application, payer contact, reference number, and effective date in the client’s credentialing tracker • Provide a weekly status report to the client contact and escalate stalled or denied applications • Protect patient information and follow HIPAA requirements

🎯 Requirements

• At least 2 years of experience in U.S. provider credentialing and payer enrollment • Hands-on experience with CAQH ProView, PECOS, and NPPES • Familiarity with commercial insurance and government health plans, including Medicare and Medicaid • Experience using payer portals and insurance websites • Comfortable making outbound telephone calls to payer provider relations and network representatives • Strong written and spoken English • Excellent attention to detail and follow-up skills • Ability to work independently and manage multiple providers and applications at the same time • Reliable internet connection and a suitable remote workspace • Experience with orthopedic or behavioral health provider enrollment is preferred • Familiarity with Texas commercial plans and Texas Medicaid is preferred • Experience with state Medicaid enrollment portals in more than one state is preferred • Experience using AdvancedMD, Practice Fusion, or TherapyNotes is preferred • Must be available during U.S. Central Time business hours

🏖️ Benefits

• Potential to move to full-time as credentialing volume grows • Remote work arrangement • Approximately 20 hours per week • Philippines-based applicants preferred