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Provider Enrollment & RCM Support Specialist
Hire OverseasDavao Region, PH6 days ago
Job type
- Quick Apply
Job descriptionOwn end-to-end credentialing as the company expands into new states. Research payer requirements, prepare submission packets, manage deadlines, and proactively escalate blockers. Build state-specific credentialing playbooks so processes are standardized and repeatable. Manage both group and individual provider credentialing , including group enrollment with payers and onboarding of each BCBA / RBT under that umbrella. Track expirations, revalidations, and renewals to ensure credentials never lapse. Build and maintain a credentialing tracker with payer timelines, statuses, and blockers — maintaining full visibility. Forecast provider go-live dates and align them with state approvals. Proactively notify providers when they’re approved and in-network. Where delays occur, propose temporary solutions (e.g., single-case agreements or alternative payer panels) to minimize idle time. Own the full payer workflow : Verification of Benefits (VOB) → Authorizations → Fee Schedule setup → Payer integration in the platform — ensuring all data is accurate and complete. Conduct regular audits to confirm payer details are correctly configured. Proactively manage new payer onboarding , ensuring workflows are fully executed and payers properly set up. Support copay / coinsurance collection and implement tracking for payment plans. Conduct payer research —document eligibility, coverage limits, claim submission processes, and reimbursement policies to reduce denials and streamline credentialing. Ensure compliance with CMS billing standards, NCQA guidelines, and delegated credentialing requirements. Develop simple checklists and spot-audits to maintain clean, compliant processes. Support the company’s transition to in-house RCM operations and take ownership of key workflows. Take on adaptive operations or RCM projects —tightening payer workflows, fixing billing leaks, or filling temporary process gaps as the company scales. Monitor Medicaid and government payer rule changes , maintaining a simple alert system to ensure compliance and avoid claim disruptions. 5+ years of experience in Revenue Cycle Management (RCM) within the healthcare industry. Proven background in healthcare operations, provider credentialing, or payer management. Highly organized and proactive, with strong ownership of end-to-end processes. Excellent at maintaining trackers, dashboards, and documentation for visibility and accountability. Extremely detail-oriented and capable of identifying compliance gaps before they escalate. Comfortable working cross-functionally with internal teams and external payers. Adaptable and able to pivot as payer rules or company needs evolve. Strong communicator with excellent written and spoken English. Zero provider idle time due to credentialing or enrollment delays. 100% payer workflows completed accurately and on time. Reduced claim denials through proactive research and compliance audits. Up-to-date regulatory compliance across all payer types and states. Smooth transition of RCM processes to in-house operations. ✅ Your updated resume ✅ A 1–2 minute Loom video introducing yourself and outlining your experience in credentialing or RCM ✅ Work samples such as dashboards, trackers, or process documentation Initial Application - Submit your application and complete our prequalifying questions Video Introduction - Record a brief video introduction to showcase your communication skills and work experience Role-Specific Assessment - Complete a homework assignment tailored to the position (if applicable) Recruitment Interview - Initial screening with our talent team Executive Interview - Meet with senior leadership to discuss role alignment Client Interview - Final interview with the client team you'd be supporting Job Offer - Successful candidates receive a formal offer to join the team
Our client is looking for a detail-oriented, process-driven Provider Enrollment & RCM Support professional who can manage the end-to-end credentialing and revenue cycle processes as the company expands into new states.
This role is ideal for someone who thrives on structure, accuracy, and proactive problem-solving — ensuring no provider sits idle and every payer workflow runs seamlessly.
🎁 Perks & Benefits
- 💵 Paid in USD every 15th & 30th of the month
- 🌴 Up to 14 days of Paid Time Off annually (starting Day 1)
- 📅 Observance of Holidays (based on your location)
- 🏡 100% remote – work from anywhere
- 🌍 Be part of meaningful, high-impact international projects
- 🚀 Work with a fast-moving team where your ideas matter
🧩 What You’ll Be Doing
🩺 Credentialing & Enrollment
💰 Revenue Cycle Management (RCM)
✅ Who You Are
🎯 Success Metrics
📩 How to Apply
Please submit :
Only candidates who submit a Loom video will be moved to the next step of the hiring process.
📋 Application Process Overview
Our comprehensive selection process ensures we find the right fit for both you and our clients :
Each stage is designed to evaluate your fit for the role while giving you insights into our company culture and expectations. We'll keep you informed throughout the process and provide feedback at each step.
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Support Specialist • Davao Region, PH
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