Credentialing and Provider Enrollment Specialist

Job not on LinkedIn

🔥 3 minutes ago

🇵🇭 Philippines – Remote

⏱ Part Time

🟢 Junior

🟡 Mid-level

✨ Provider Enrollment Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 16%

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.

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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, 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 • 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 applications are 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

🎯 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 • Experience credentialing surgeons or specialty practices such as orthopedics, spine, or pain management (preferred) • Experience enrolling a newly formed group practice, including multiple locations (preferred) • Familiarity with Georgia Medicaid and Georgia commercial insurance plans (preferred) • Experience with hospital and ambulatory surgery center privileging (preferred)

🏖️ Benefits

• Remote work arrangement • Part-time schedule • Must be available during Eastern Time business hours