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 pay