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