Regulatory Operations Specialist

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