Credentialing Specialist

Overview Virtual Rockstar is hiring a Credentialing Specialist - Virtual Assistant on behalf of a multi-location pediatric therapy practice based in Minnesota. The organization provides life-changing occupational, physical, and speech therapy services to children and families. The Credentialing Specialist will ensure providers are credentialed accurately and efficiently across multiple insurance payers. This is a remote position. You will join a collaborative and mission-driven team dedicated to helping children reach their fullest potential. Responsibilities Provider Credentialing Create and manage new provider profiles in CAQH and maintain updates for existing providers Obtain NPI numbers and manage all related documentation Complete Medicare and Medicaid (MA) enrollments via PECOS Online Portal Establish and maintain payer connections for new and existing therapists Monitor the credentialing tracker daily, following up with insurance payers as needed via email or phone Save all confirmation documents in provider folders and update credentialing statuses in internal systems (e.g., Linus) Process offboarding for departing therapists by notifying payers and closing active enrollments Insurance Communication & Denial Follow-up Contact insurance companies when credentialing applications are denied or delayed to identify and resolve issues Maintain professional and timely communication with payer representatives Document all correspondence and updates for internal records Billing Support Collaborate with the billing department to follow up on unpaid or denied claims Assist with appeals and claim resubmissions as directed by the billing lead Track and report on outstanding claims and trends in payer responses HR Administrative Support Organize and maintain digital credentialing and HR files Support reporting and compliance documentation for internal and external audits Assist with HR tasks as needed Qualifications & Requirements Experience & Knowledge 2+ years of experience in provider credentialing, payer enrollment, or medical billing support (preferably in a therapy or multi-site healthcare setting) Strong understanding of CAQH, NPI, Medicare, and Medicaid (MA) enrollment processes Familiarity with insurance payers, credentialing workflows, and medical billing systems Experience in following up with insurance companies and managing appeals Technical Skills Proficient with Microsoft Office 365 (Word, Excel, Outlook, Teams) Comfortable using ticketing or workflow systems for communication and task management Strong data entry and documentation skills with high attention to detail Soft Skills Excellent communication and follow-up abilities (email and phone) Highly organized and deadline-driven Ability to work independently while collaborating with billing and HR teams Professional, dependable, and proactive in problem-solving Benefits Competitive salary commensurate with experience Opportunities for professional development and growth Work in a dynamic and supportive team environment Make a meaningful impact by helping to build and strengthen families across the globe #J-18808-Ljbffr