Contracting and Credentialing Specialist

XRHEALTH INC; Florida; Hybrid; USD 34,000 - 55,000; Part time

Benefits offered by this job

Company laptop provided

Fully remote work

Job summary

XRHealth USA Inc. seeks a hands-on Contracting and Credentialing Specialist to own the enrollment, credentialing, and government registration lifecycle for clinicians and entities, including Medicare/Medicaid enrollments and state/federal registrations.

The role focuses on CMS I&A and PECOS, maintaining enrollments across multiple states, and delivering a clean, tracked process with zero lapsed enrollments. Remote work with ownership of deadlines and documentation.

Qualifications

• 3+ years of hands-on provider enrollment and credentialing experience.
• Direct, independent CMS I&A and PECOS experience.
• Multi-state Medicaid and commercial payer enrollment experience.
• Familiarity with CAQH, NPPES, and payer credentialing portals.

Responsibilities

• Own enrollment, credentialing, and government contracting lifecycle for clinicians and entities.
• Prepare, submit, and track CMS enrollment applications (CMS-855B, 855I, 855R, 855O, CMS-588, EDI).
• Manage reassignments of benefits, group enrollments, and licensure support.
• Maintain SAM.gov registration, UEI, CAGE code, and annual renewals for government contracting.
• Deliver weekly status updates on credentialing activities and deadlines.

Skills

Provider enrollment

Credentialing

CMS I&A

PECOS

Multi-state Medicaid enrollment

Payer credentialing portals

Documentation

Written communication

Job description

Contracting and Credentialing Specialist

We're looking for a hands-on credentialing and government contracting specialist to own the enrollment, credentialing, and government registration lifecycle for our clinicians and entities. This is detailed, deadline-driven work: Medicare and Medicaid enrollments, revalidations, payer applications, state licensure support, and federal/state contracting registrations.

This role is ideal for someone who knows PECOS and CMS I&A, can work independently without hand-holding, and takes satisfaction in a clean tracker and zero lapsed enrollments. You'll work directly with our leadership team and have real ownership over your workstream.

What You'll Own

• Maintain CMS Identity & Access (I&A) accounts, surrogate relationships, and PECOS access for providers and organizations
• Prepare, submit, and track CMS-855B, 855I, 855R, 855O, CMS-588 (EFT), and EDI enrollment applications
• Manage reassignments of benefits, group enrollments, practice location changes, and ownership/managing-control disclosures
• Own the revalidation calendar - no missed deadlines, ever
• Correspond with MACs on development requests, name-matching issues, and application deficiencies; escalated and follow through to approval

Medicaid

• Complete and track state Medicaid enrollments and re-enrollments across multiple states
• Maintain CAQH ProView profiles, NPPES/NPI records, and payer portal access
• Track application status, effective dates, and par/non-par status in our credentialing tracker; report status weekly

Government Contracting

• Maintain SAM.gov registration, UEI, CAGE code, and annual renewals
• Support VA community care network enrollment (TriWest/Optum), state contracts, and other public-sector opportunities
• Prepare and update capability statements, representations and certifications, and required entity documentation
• Monitor solicitations and flag relevant opportunities; assemble supporting documents for bids and RFPs

Documentation & Process

• Keep entity documentation organized and current (EINs, IRS Letter 147C, W-9s, state registrations, registered agent records, MSO/PC structure documents used in payer applications)
• Maintain and improve credentialing SOPs and trackers
• Deliver a concise weekly status report: what moved, what's blocked, what's at risk

Required Qualifications

• 3+ years of hands-on provider enrollment and credentialing experience
• Direct, independent experience with CMS I&A and PECOS
• Multi-state Medicaid and commercial payer enrollment experience
• Working knowledge of CAQH, NPPES, and payer credentialing portals
• Strong written communication — you'll be drafting payer and agency correspondence on our behalf
• Meticulous documentation habits and comfort managing dozens of parallel deadlines
• U.S.-based, with a Social Security Number (required to establish individual CMS I&A credentials)
• Reliable high-speed internet and a private, HIPAA-appropriate work environment

Preferred Qualifications

• CPCS or CPMSM certification
• Telehealth or multi-state virtual care experience
• Experience with group practice enrollments under an MSO or management services structure
• Experience with VA community care networks (TriWest, Optum)
• Familiarity with therapy disciplines (PT/OT/SLP) and behavioral health credentialing requirements

Schedule & Work Arrangement

• Part-time, hourly, W2 - hours will not exceed 29 hours per week
• Schedule is flexible within standard U.S. business hours, with availability required for payer and MAC phone calls during business hours
• Fully remote; company laptop provided for all work
• Accurate time tracking is required; all hours must be recorded and approved

Hiring Process

• Reference check and background check

XRHealth USA Inc. is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other protected characteristic. Employment is contingent on successful completion of a background check and exclusion screening (OIG, SAM, OFAC).

This position is employment at will. Nothing in this posting constitutes a contract or guarantee of employment or of any minimum number of hours.

About XRHEALTH INC

XRHealth delivers virtual care through virtual reality. We provide physical therapy, occupational therapy, speech-language pathology, mental health therapy, and nurse practitioner services — 100% remotely, across multiple states. We're a lean, fast-moving, fully remote team that operates under an MSO-pro professional corporation structure, and we're building a clinical operation that is both clinically excellent and financially disciplined.