Provider Credentialing Specialist

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 Originally posted on Himalayas