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