via Remote Rocketship
$120K - 200K a year
Manage credentialing operations, monitor application processes, ensure data accuracy, and develop protocols for payor onboarding.
Requires at least 2 years of experience as a Certified Provider Credentialing Specialist or 4 years in Provider Enrollment, with strong knowledge of credentialing resources and excellent communication skills.
Job Description: • Ensuring our providers are credentialed in a timely manner by monitoring and maintaining the end-to-end submission process for 10-20 of our payors. • Monitor our submission processes to make sure that all applications are submitted within SLA. Understand our submission protocols and update them as needed. Manage Virtual Assistants/BPO throughout this process. • Monitor the follow up process applications, and communicate with the payors directly to ensure that applications are staying on-track. • Conduct regular reviews to validate the accuracy of our internal credentialing data against the payor’s data to ensure our credentialing data serves as a source of truth across the organization. • Maintain documentation for each process to ensure smooth operations. • Work with the Revenue Cycle Management team on any Credentialing related claim denials. • Assist in building out new payor operations as we onboard new payors. • Create the Submission Protocol for new payors so that applications can be submitted in a standardized format. • Work with the payor to understand the best way to follow up on applications, and document the process accordingly. • Determine the best way to regularly review the accuracy of internal credentialing data whether it be requesting a report from the payor or checking a portal. • Provide a synthesis of each payor’s credentialing operations to the Manager, Provider Enrollment on an as needed based off the data you’re monitoring in our credentialing system. • Manage special projects as needed. Requirements: • Certified Provider Credentialing Specialist (CPCS) with at least two years of experience in Provider Enrollment OR at least four years of experience in Provider Enrollment • Strong familiarity with credentialing processes, terminology and primary source verification resources; these include: CAQH, NPDB, PECOS, State Licensing, Accreditation and Certification agencies • Excellent communication skills. You have the ability to be persuasive and credible with a wide variety of audiences both internal and external. • You know how to hold people accountable. You drive clarity on what’s needed to get something done, and you ensure deadlines are met. • You’re tech savvy. You’ve efficiently learned new software in the past, and you’re willing to learn HubSpot, Verifiable, Slack, and Excel if you don’t know how to use them already. Benefits: • Comprehensive Health Coverage: Medical, dental, and vision insurance, plus life and disability coverage. • Parental Leave & Family Support: Up to 18 weeks paid leave and a new child stipend. • Financial Wellness: 401(k) program and equity opportunities. • Meals & Home Office Support: Stipends for home office setup and ongoing funds for meals, with tailored perks for both remote and in-office employees. • Time Off to Recharge: Flexible PTO, 12 paid holidays, and a full winter break week. • Wellness & Development: Annual stipends to put towards personal & professional growth. • Mental & Physical Health Support: No-cost access to therapy through the Grow platform, weekly flexible hours for self-care (“Mental Health Mornings/Afternoons”) and memberships to leading wellness apps (such as One Medical, Headspace, and Talkspace). • Extra Perks: Pet insurance discounts, commuter benefits, and global travel assistance.
This job posting was last updated on 1/26/2026