Provider Credentialing Specialist

Rockstar; Manila; Remote; PHP 3,839,000 - 5,758,000; Full time

Job summary

Rockstar in Arizona-based staffing company connects healthcare practices with remote professionals. This remote Provider Credentialing Specialist role supports US-based clients, handling the full enrollment lifecycle from initial submission to re-credentialing, ensuring accuracy and timely follow-up.

You will manage CAQH profiles, payer enrollments, sanctions checks, and serve as a main contact for providers and payers. Depending on client, may assist light billing tasks.

Qualifications

• 2+ years of hands-on provider credentialing experience.
• Experience managing full credentialing workflows: submission, follow-up, re-credentialing.
• Strong knowledge of CAQH, NPI enrollment, and payer requirements.
• Experience with Medicare, Medicaid, and commercial enrollment processes.
• Proactive follow-up with payers and providers.
• Excellent English communication and written skills.
• Strong organizational and deadline-management abilities.

Responsibilities

• Gather required documentation from providers to initiate credentialing.
• Prepare, complete, and submit credentialing applications for new providers across commercial and government payers.
• Complete re-credentialing applications as due and submit ahead of expiration deadlines.
• Submit and track NPI, PECOS, and Medicare/Medicaid enrollments.
• Manage multi-state credentialing processes and payer-specific requirements.
• Track all active applications, submission dates, and payer responses.
• Maintain credentialing confirmations and update trackers.
• Create and maintain CAQH profiles for new providers; attestations and data upkeep.
• Perform monthly sanctions checks and keep records audit-ready.
• Follow up with payers by phone/email; escalate delays when needed.
• Assist with offboarding of departing providers and update records.
• Light billing/accounts receivable support if necessary.

Skills

Provider credentialing

CAQH proficiency

NPI enrollment

Payer follow-up

Multi-state credentialing

Attention to detail

Communications (English)

Remote work

Tools

Microsoft Office Suite

Google Workspace

Job description

Rockstar is an industry-leading staffing company based in Arizona that helps healthcare businesses across the United States streamline operations by connecting them with skilled remote professionals. We partner with talented individuals from around the world, providing meaningful remote career opportunities that empower personal and professional growth.

At Rockstar, we are committed to placing team members who not only meet our clients' operational needs but who also reflect our core values of integrity, excellence, and long-term service. Every placement is an opportunity to make a meaningful difference, for the practice, for patients, and for you.

Job Description

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

• 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
  
• 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