Contracting and Credentialing Specialist

XRHealth•Tampa, FL

1d•Remote

About The Position

XRHealth delivers virtual care through virtual reality, providing physical therapy, occupational therapy, speech-language pathology, mental health therapy, and nurse practitioner services remotely across multiple states. They are a lean, fast-moving, fully remote team operating under an MSO–professional corporation structure, focused on clinical excellence and financial discipline. This role is for a hands-on credentialing and government contracting specialist responsible for the enrollment, credentialing, and government registration lifecycle for clinicians and entities. This involves detailed, deadline-driven work including Medicare and Medicaid enrollments, revalidations, payer applications, state licensure support, and federal/state contracting registrations. The ideal candidate is proficient with PECOS and CMS I&A, works independently, and maintains accurate tracking with no lapsed enrollments. This role offers direct collaboration with the leadership team and significant ownership.

Requirements

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 skills for drafting payer and agency correspondence.
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.

Nice To Haves

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

Responsibilities

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, ensuring no missed deadlines.
Correspond with MACs on development requests, name-matching issues, and application deficiencies, escalating and following through to approval.
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 the credentialing tracker and report status weekly.
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.
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 detailing progress, blockers, and risks.