What are the responsibilities and job description for the Contracting and Credentialing Specialist position at XRHealth?
About XRHealth
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–professional corporation structure, and we're building a clinical operation that is both clinically excellent and financially disciplined.
About the Role
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
Medicare (CMS / PECOS / I&A)
- 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; escalate 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
- 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, 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
- Application review & 10-minute screening interview. Complete screening interview here: https://myint.video/aML7Y-ML-e
- 30-minute live interview
- 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.