Contracting and Credentialing Specialist (Ashley)

About XRHealth Inc.

XRHealth delivers virtual care through virtual reality, providing physical therapy, occupational therapy, speech‑language pathology, mental health therapy, and nurse practitioner services — 100% remotely across multiple states. The company operates as a lean, fast‑moving, fully remote team under an MSO–professional corporation structure, building a clinical operation that is both clinically excellent and financially disciplined.

About the Role

We are 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 detailed, deadline‑driven work includes Medicare and Medicaid enrollments, revalidations, payer applications, state licensure support, and federal/state contracting registrations. The ideal candidate knows PECOS and CMS I&A, works independently, and takes satisfaction in a clean tracker and zero lapsed enrollments. You will work directly with our leadership team and have real ownership over your workstream.

Responsibilities

• Medicare (CMS / PECOS / I&A): Maintain CMS Identity & Access 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/control disclosures; own the revalidation calendar with no missed deadlines; correspond with MACs on development requests, name‑matching issues, and application deficiencies, escalating 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 the credentialing tracker and 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, flag relevant opportunities, and 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 covering progress, blockers, and risks.

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 skills for drafting payer and agency correspondence.
• Meticulous documentation habits and ability to manage 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.
• 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.

Schedule & Work Arrangement

• Part‑time, hourly, W‑2; hours will not exceed 29 hours per week.
• Flexible schedule within standard U.S. business hours; availability required for payer and MAC phone calls during business hours.
• Fully remote; company laptop provided.
• Accurate time tracking required; all hours must be recorded and approved.

Hiring Process

• Application review and 10‑minute screening interview.
• 30‑minute live interview.
• Reference check and background check.