Introduction
Retina Consultants of America is identifying and evaluating candidates for the position of Platform Credentialing Specialist. This role reports to the Platform Credentialing Supervisor and supports hands-on credentialing and payer enrollment activities related to physician onboarding, practice transitions, and acquisitions across the RCA platform.
This position focuses on completing and supporting credentialing work to ensure providers are enrolled and activated accurately and efficiently. The role plays an important part in helping minimize delays related to credentialing and payer enrollment by performing application submission, follow-up, and issue resolution in coordination with internal teams, practices, and payers.
Our Company
Retina Consultants of America (RCA) is bringing together national leaders in surgical and clinical retina care. This network comprises preeminent retina research specialists with the common goal of eradicating blindness caused by macular degeneration, diabetic retinopathy, and other retina diseases.
With over 2.3 million annual patient visits, more than 315 physicians, and over 290 locations, Retina Consultants of America (RCA) is the largest retina care provider in the nation.
Our Mission
Through RCA’s physician-centered practice management model, physicians continue to drive clinical care and practice culture, while benefiting from business expertise, centralized resources, and shared best practices.
RCA seeks to expand its mission by partnering with leading retina specialists who are passionate about delivering excellent patient care and participating in innovative research.
RCA has created a business model that enables retina specialists to retain autonomy and ownership, augmented by shared best practices facilitated through medical leadership and executive management support. Practices within the network continue to drive clinical decisions while remaining highly involved in strategic operations.
Our Core Values
Relentlessly Commit to our Patients, to the Practices We Serve and to Our Mission
Embrace the Legacies of Our Partner Practices
Strive for Continuous Improvement Through Education and Research
Exude Compassion in All We Do
Position Overview
The Platform Credentialing role supports credentialing and payer enrollment activities across the RCA platform, with a focus on physician onboarding, acquisitions, and issue resolution. This position performs hands-on credentialing work, including application preparation, submission, follow-up, and payer activation, while assisting platform credentialing leadership with execution and completion of enrollment-related tasks.
The role works closely with RCM operations, practice administrators, payers, and internal teams to gather required documentation, resolve enrollment issues, and ensure providers are credentialed and activated in a timely manner. This position supports onboarding and transition efforts during growth and acquisition activity through accurate execution, tracking, and follow-through on credentialing requirements.
Essential Duties and Responsibilities
- Complete provider credentialing and payer enrollment applications for physicians and advanced practice providers, including Medicare, Medicaid, and commercial payers
- Enter, update, and maintain provider information in credentialing systems and payer portals (e.g., CAQH, PECOS, and commercial portals)
- Collect, review, and submit required documentation to support credentialing and enrollment applications
- Track application status, deadlines, and follow-up activity to ensure timely payer activation
- Follow up directly with payers, vendors, and practices to resolve outstanding items or requests for additional information
- Assist with credentialing for new physician onboarding by completing enrollments, reassignments, and payer setup
- Support acquisition-related credentialing tasks, including CHOW filings, payer notifications, and enrollment transitions
- Identify incomplete, delayed, or rejected applications and take corrective action to move them forward
- Maintain accurate credentialing records and supporting documentation in centralized tracking tools and shared systems
- Assist with Medicare enrollment, reassignment, and revalidation activities, ensuring deadlines are met
- Communicate application status, issues, and next steps clearly to internal teams and practices
- Adhere to established credentialing workflows, checklists, and documentation standards
- Assist with updating credentialing templates, forms, and intake materials as processes evolve
- Participate in credentialing-related projects or initiatives as assigned by the Platform Credentialing Supervisor
Knowledge, Skills, and Abilities
- Strong working knowledge of provider credentialing, payer enrollment, and onboarding processes, including hands-on application submission and follow-up
- Familiarity with payer requirements, timelines, and common enrollment issues, with the ability to navigate and work directly in payer portals
- Ability to complete, track, and follow credentialing and enrollment tasks through to resolution, identifying and addressing issues as they arise
- Highly organized with the ability to manage multiple active applications, deadlines, and documentation requirements simultaneously
- Clear and effective communication skills for coordinating with practices, payers, vendors, and internal teams on credentialing-related items
- Comfortable working directly with physicians, practice staff, and external partners to obtain required information and documentation
- Strong attention to detail with consistent follow-through to ensure applications are accurate, complete, and submitted on time
- Ability to work efficiently in a fast-paced, growth-oriented healthcare environment with shifting priorities
- Self-directed and dependable, with the ability to execute assigned work independently while collaborating with a broader team
- Willingness to travel as needed to support onboarding or acquisition-related credentialing activities
Education and Experience
- Bachelor’s degree in healthcare administration, business administration, or related field or 5 years of physician practice experience
- Minimum of 3 years of experience in provider credentialing, payer enrollment, or healthcare operations
- Experience supporting physician onboarding, acquisitions, or multi-site healthcare organizations strongly preferred
- Proficient in Microsoft Office (Excel, Word, PowerPoint)
- Proficient in Microsoft Outlook
- Experience navigating EHR, PM systems, and credentialing or enrollment platforms (e.g., CAQH, Medicare PECOS, commercial payer portals)
Pay: $45,000.00 - $65,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Application Question(s):
- Ability to travel 10%?
- Have you used Modio Credentialing Software?
- What states do you have provider enrollment experience?
Experience:
- provider credentialing: 3 years (Required)
Work Location: Remote
