What You'll Learn
- Build end-to-end Provider Credentialing and Payer Enrollment workflows (federal & commercial)
- Navigate PECOS, NPPES/NPI, PTAN, and the CMS-855 suite with confidence
- Set up CAQH ProView, manage attestations, and align to NCQA/URAC credentialing standards
- Complete Medicare/Medicaid enrollment, EFT/EDI/ERA/835 setup, and revalidation tracking
- Handle commercial insurances paneling, contracting basics, and roster updates
- Perform Primary Source Verification (PSV) and manage expirables (licenses, DEA, malpractice)
- Resolve credentialing denials, write effective appeals, and mitigate compliance risk
- Use templates and automation to speed cycle time and support revenue cycle management goals
Requirements
- No prior credentialing experience required—beginner friendly
- A computer with internet access and basic document skills (PDFs, spreadsheets)
- Comfort reading official payer/CMS instructions (ESL-friendly course)
- Willingness to practice using provided checklists, trackers, and scripts
Who This Course is For
- New or aspiring credentialing coordinators and payer enrollment specialists
- Medical billing/RCM staff who touch contracting, enrollment, or provider setup
- Practice managers and clinic owners needing in-house credentialing capability
- Freelancers/virtual assistants building a credentialing/contracting service
- Healthcare IT and vendor teams integrating provider data, EDI, or payer portals
- Recent grads or career-changers entering non-clinical healthcare operations
Your Instructor
RCM Academy
Master Healthcare RCM & Medical Billing with RCM Academy
4.4 Instructor Rating
912 Reviews
12,992 Students
31 Courses
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