Remote 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 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.