Provider Enrollment & RCM Support Specialist

Our client is looking for a detail-oriented, process-driven Provider Enrollment & RCM Support 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 • 💵 Get paid in USD every 15th & 30th of the month • 🌴 Up to 14 days paid time off annually, from day 1 • 📅 Observance of paid Philippine Regular Holidays (Flexibility of Holidays depending on place of residency) • 🏡 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 Do 🩺 Credentialing & Enrollment • Own end-to-end credentialing as they expand into new states. Research payer requirements per state, prepare submission packets, manage deadlines, and proactively escalate blockers. Build state-specific credentialing playbooks so the process is repeatable. • Manage both group credentialing and individual provider credentialing. Coordinate initial group enrollment with each payer and then onboard each BCBA/RBT under that umbrella. Track expirations, revalidations, and renewals so credentials never lapse. • Build and maintain a credentialing tracker with status, payer timelines, and blockers. Keep a live dashboard that shows exactly where each provider/state stands. • Ensure no provider sits idle due to credentialing delays. Forecast provider go-live dates and align them with state approvals, and promptly notify providers when they’re approved and in-network. Where delays are likely, propose temporary solutions (e.g., assigning to a different payer panel, using single-case agreements) so every provider starts as soon as possible. 💰 Revenue Cycle Management (RCM) • End-to-end ownership: Manage the full payer workflow - Verification of Benefits (VOB) → Authorizations → Fee Schedule setup → Payer integration in the platform - ensuring data is accurate, current, and complete. • Audit for completeness: Regularly check that payer details are correctly configured on the platform (or Monday). • New payer onboarding: When we add new payers, proactively ensure the entire workflow is followed all the way through and the payer properly set up. • Copay/Coinsurance: Support copay/coinsurance collection, implement payment plan tracking for copy/coinsurance families. • Payer Research: Investigate and document each insurer’s requirements - eligibility checks, coverage limits, claim submission processes, reimbursement policies. Summarize findings into clear, practical references for the team to reduce denials and speed credentialing. • Compliance & Quality Assurance: Ensure every action in credentialing, billing, and support adheres to payer rules and industry standards (e.g., CMS billing, NCQA guidelines, delegated credentialing). Develop simple checklists and spot-audits to keep processes clean, compliant, and trusted. • Support their plan to transition RCM in-house. • Adaptive Responsibilities: Take on evolving ops/RCM projects as Tellos grows - tightening payer workflows, fixing billing leaks, or stepping in on short-term gaps. Stay agile as payer rules shift, ensuring no cracks in process execution. • Regulatory Monitoring: Stay ahead of Medicaid and government payer rule changes by actively tracking updates, bulletins, and policy revisions. Build a simple alert system so we catch shifts before they impact claims. ✅ Who You Are • At least 5 years of experience in Revenue Cycle Management (RCM) within the healthcare industry. • Proven experience in healthcare operations, provider credentialing, or revenue cycle management. • Highly organized and proactive, with strong ownership of end-to-end processes. • Excellent at maintaining trackers, dashboards, and documentation for visibility and accountability. • Detail-obsessed and capable of catching compliance gaps or delays before they become problems. • Comfortable working cross-functionally with internal teams and external payers. • Adaptable — able to pivot quickly as payer rules or company needs evolve. • Strong communicator with excellent written and spoken English skills. 🎯 Success Metrics • Zero provider idle time due to credentialing or enrollment delays. • 100% payer workflows completed on time and accurately. • Reduced claim denials through proactive payer research and compliance audits. • Up-to-date regulatory compliance across all states and payer types. • Smooth transition of RCM processes in-house. 📩 How to Apply Please submit: • ✅ Your updated resume • ✅ A 1–2 minute Loom video introducing yourself and outlining their experience in credentialing or RCM • ✅ Work samples such as dashboards, trackers, or process documentation