Description
Regulatory Operations Specialist (PECOS, Vendors & Credentialing)
Position Summary
The Regulatory Operations Specialist supports day-to-day PECOS filings, vendor regulatory documentation, and provider credentialing activities. This role is execution-focused and detail-driven, ensuring regulatory records are accurate, current, and audit-ready.
Key Responsibilities
PECOS & Enrollment Support
- Prepare and submit PECOS enrollments, revalidations, and updates under supervision.
- Collect, organize, and maintain required ownership, managing employee, and practice location documentation.
- Track CMS and MAC correspondence and assist with responses.
Vendor Regulatory Support
- Collect and maintain required regulatory documentation for vendors and contractors.
- Track expirables and ensure timely updates of required certifications and attestations.
- Assist with regulatory onboarding and offboarding documentation.
Credentialing Support
- Support credentialing activities, including license verification, certification tracking, and documentation management.
- Maintain credentialing files and ensure alignment with enrollment and payer requirements.
- Monitor expirables and notify leadership of upcoming renewals.
Documentation & Tracking
- Maintain regulatory trackers, calendars, and filing logs.
- Ensure records are organized, complete, and audit-ready.
- Assist with internal audits and data validation reviews.
Collaboration
- Coordinate with HR, Compliance, Operations, and Revenue Cycle to gather required information.
- Escalate discrepancies or risks promptly to leadership.
Requirements
Required
- Associate or Bachelor’s degree in healthcare administration or related field.
- 2–4 years of experience in healthcare regulatory operations, credentialing, or enrollment support.
- Strong attention to detail and ability to manage multiple deadlines.
Preferred
- Hands-on PECOS experience.
- Experience supporting Medicare enrollment or credentialing in post-acute care.
- Familiarity with document management systems.
Core Competencies
- Regulatory accuracy and documentation
- Process discipline and follow-through
- Time and deadline management
- Cross-functional communication
