Provider Credentialing Specialist

This a Full Remote job, the offer is available from: United States This is a remote position. Rockstar is seeking an experienced Provider Credentialing Specialist to support U.S.-based healthcare practices on a full-time remote basis. This is a credentialing-first role built for professionals who understand the full provider enrollment lifecycle, from initial application through re-credentialing and payer follow-up, and who take pride in keeping processes accurate, organized, and moving forward without gaps. In this role, you will manage provider credentialing and re-credentialing workflows, complete payer enrollments, maintain CAQH profiles, conduct sanctions checks, and serve as a reliable point of contact for providers and payers alike. Depending on the client, you may also provide light support to billing and accounts receivable functions as a secondary responsibility. This role is ideal for someone who is detail-oriented, deadline-driven, and confident making follow-up calls to insurance payers: someone who doesn't let applications sit and knows exactly what to do when a payer goes quiet. KEY RESPONSIBILITIES Provider Credentialing & Enrollment • Gather required documentation from new and existing providers to initiate credentialing • Prepare, complete, and submit credentialing applications for new providers across commercial and government payers • Complete re-credentialing applications as they come due and ensure submissions are made ahead of expiration deadlines • Submit and track NPI enrollment, PECOS enrollment, and Medicare/Medicaid applications as required • Manage multi-state credentialing processes and payer-specific enrollment requirements • Track all active credentialing applications, submission dates, payer responses, and approval confirmations • Save credentialing confirmations in provider files and update credentialing trackers accordingly CAQH, Sanctions & Compliance • Create and maintain CAQH profiles for new providers, ensuring all information is accurate and current • Complete CAQH attestations on schedule and keep provider data up to date across all payer portals • Perform monthly sanctions checks for all providers and document results consistently • Maintain organized, compliant, and audit-ready credentialing records at all times • Stay current on payer credentialing requirements, enrollment changes, and industry updates Payer Follow-Up & Communication • Proactively follow up with insurance payers via phone and email to confirm receipt, check application status, and resolve outstanding items • Coordinate with providers to ensure required documentation is submitted completely and on time • Serve as a key point of contact for credentialing-related questions from providers, payers, and internal teams • Escalate credentialing delays or payer issues to leadership when timelines are at risk • Maintain clear records of all payer communications, follow-up dates, and credentialing decisions Provider Offboarding • Manage credentialing offboarding processes when providers depart, including payer notification and record updates • Ensure departing providers are properly removed from active payer rosters and internal trackers Billing & Administrative Support (Where Applicable) • Depending on the client, this role may include light support for billing and accounts receivable workflows as time allows, including claims follow-up, payer calls related to unpaid or denied claims, and general administrative coordination to keep revenue cycle operations moving. Requirements Required • 2+ years of hands-on provider credentialing experience: this is not an entry-level role • Proven experience managing full credentialing workflows: application submission, payer follow-up, re-credentialing, and documentation • Strong working knowledge of CAQH, NPI enrollment, and payer-specific credentialing requirements • Experience with Medicare, Medicaid, and commercial payer enrollment processes • Comfortable making proactive follow-up calls to insurance payers and requesting information from providers • Exceptional attention to detail and deadline management: accuracy and follow-through are essential in this role • Strong organizational skills with the ability to manage multiple active credentialing workflows simultaneously • Excellent written and verbal English communication skills • Proficiency with Microsoft Office Suite (Word, Excel, Outlook) or Google Workspace • Reliable home office setup with a stable internet connection Preferred • Experience credentialing Physical Therapists (PTs), Occupational Therapists (OTs), or Speech-Language Pathologists (SLPs) • Familiarity with PECOS and CMS enrollment portals • Experience supporting multi-provider or high-volume clinic environments, including traveling or contract providers • Background in multi-state credentialing processes • Familiarity with EMR or practice management platforms • Light experience with billing or accounts receivable follow-up WHAT WE LOOK FOR • Ownership: you track every application from submission to approval and don't let anything sit unresolved • Persistence: when a payer goes quiet, you follow up; you know how to navigate the system and get answers • Precision: credentialing errors have real consequences; you catch mistakes before they become problems • Organization: your trackers are clean, your deadlines are met, and nothing expires on your watch • Professionalism: you communicate clearly and confidently with providers, payers, and leadership alike Benefits • Competitive salary commensurate with experience • Opportunities for professional development and long-term career growth • Work within a dynamic, collaborative, and supportive team environment • Stable, full-time remote employment with U.S.-based clients • Make a meaningful impact by helping businesses grow their brand and connect with the communities they serve Salary: $7.00-8.00This offer from "Virtual Rockstar Careers" has been enriched by Jobgether.com and got a 72% flex score.