Regulatory Operations Specialist
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AI Summary
The role focuses on managing PECOS filings, vendor regulatory documentation, and provider credentialing activities. It ensures all regulatory records are accurate, current, and ready for audits through diligent tracking and coordination.
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
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