- August 14, 2025
- Credentialing
Hospitals and health systems are facing increasing pressure to onboard providers quickly and accurately. Time and accuracy matter as delays in payor enrollment can keep a provider from seeing patients and result in lost revenue for the healthcare organization.
The expertise and skill of your credentialing team does matter. Modio’s Extended Credentialing Services (XCS) team universally have their Provider Enrollment Specialist Certification (PESC), which showcases their expertise in a growing market and makes them better prepared to stay ahead of industry demands.
Susan Collier, VP of Quality Management and Operational Services, explains, “Achieving this certification demonstrates to our clients that they are working with a team of professionals that has achieved the highest level of proficiency in payor enrollment services.”
Why this matters
Tasked with guiding providers through the payor enrollment process, Modio’s XCS team is helping clients tackle one of the industry’s biggest bottlenecks. It demonstrates expertise in the process of enrolling healthcare providers with insurance payors, including Medicare and Medicaid. It signifies a strong understanding of CMS guidelines, PECOS (Provider Enrollment, Chain, and Ownership System), and various enrollment forms. The PESC, offered by DecisionHealth, is currently the only industry-recognized program designed specifically for payor enrollment professionals. It’s a rigorous process, requiring specialists to demonstrate deep knowledge of Medicare and Medicaid regulations, plus the nuances of commercial insurer requirements.
“Achieving PESC demonstrates to our clients that they are working with a team of professionals that has earned a level of competency in payor enrollment services,” said Susan. “It’s the only certificate available for professionals to showcase their mastery in a growing market.”
And it’s not an easy badge to earn. The assessment consists of 50 in-depth questions and requires an 80% passing grade.
Improving industry averages
What makes this investment in professional development such as PESC more than just symbolic is the real impact on performance. James Summers, Director of Client Services for Modio, says that’s a big deal. “If you ask the industry, they’re going to say that typically it takes anywhere from 90 to 120 days to enroll. We’re averaging about 60.”
Building trust
For XCS team member Karen Brown, a credentialing veteran, the certification is more than a formality. It’s a way to validate the years of work they’ve put in and to stay current in a rapidly evolving field.
“I feel like I have that outward stamp of approval behind my name,” said Karen. “We’re reassuring clients that we’re continually growing in our industry.”
It’s an acknowledgement that says not just to clients, but internally within Modio, we’re not just doing this job, we’re also doing it right.
In an environment where insurance rules shift frequently and providers need to be credentialed across 10 to 20 different payors, staying nimble is non-negotiable.
Rachel Woodhouse who leads the XCS team notes that every week there’s a new requirement or form or process to track — having a team that’s trained, certified, and deeply experienced is the only way to keep up and keep providers from falling through the cracks.
A model for the future of credentialing
With over 70% of the XCS team already certified and others actively pursuing it, often with support through Modio’s parent company CHG Healthcare, the team is raising the bar.
And while certification isn’t mandatory, the results speak for themselves: faster turnaround, greater trust from clients, and a stronger, more skilled workforce ready to meet tomorrow’s challenges.
Ideally this is where provider credentialing is headed, not just checking boxes, but building teams that bring strategy, speed, and professionalism to every step of the payor enrollment process.
To learn more about how Modio can help your payor enrollment process, please visit us here.