Credentialing and Provider Enrollment Specialist

. Prepare, submit, and track Medicare enrollment applications through PECOS, including individual, group, and reassignment of benefits applications .

Posted 10/16/2026part-timeRemote • PhilippinesJuniorMid-LevelWebsite

Key responsibilities & impact

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

What you’ll need

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)

Comp & perks