Credentialing Lead

 Posted 2 days ago
  
 Worldwide
  
2-5 years experience
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AI Summary

Design and launch a new end-to-end credentialing service, including building workflows and quality standards. Manage the entire operation from application intake and payer enrollment to hiring and scaling a team of specialists.

This is a remote position.

The Role

We're building Rockstar Credentialing, a new end-to-end credentialing service for private practices. This role has a unique opportunity to build this service offering from the ground up! 

Credentialing is one of the most expensive bottlenecks in a therapy practice. A provider who isn't credentialed can't bill insurance, can't get paid, and can't see patients under a payer plan, no matter how qualified they are. Initial credentialing with commercial payers typically takes 90 to 120 days, Medicare enrollment through PECOS runs 60 to 90 days, and payers now require continuous monitoring of licenses, sanctions, and exclusion lists rather than periodic checks. Miss a step and a practice loses revenue it can't easily recover.

We're building a service that takes that entire burden off practice owners: primary source verification, CAQH management, payer enrollment, recredentialing, ongoing compliance monitoring, all of it, done right and done fast. This role is the person who builds that service and runs it.


What You'll Do

Stand up the service. You'll help design and launch Rockstar Credentialing from the ground up. That means building the workflows, setting the quality standards, choosing the tools, and defining what “done right” looks like for every credentialing file that comes through. You're not inheriting a playbook. You're writing it.

Own the operation end to end. Once it's live, you run it. Application intake, primary source verification, CAQH profile management, payer and Medicare/Medicaid enrollment, recredentialing cycles, and ongoing license and sanctions monitoring all sit with you. You're accountable for turnaround time, accuracy, and compliance across every file.

Build and scale the team. You'll hire, train, and manage the credentialing specialists who do this work day to day. As practice partners come on board, you'll grow the team to match, without letting quality slip.

Keep practices compliant and paid. You'll track every provider's status across every payer, catch expirations and gaps before they become problems, and make sure no practice partner loses billing privileges because a step got missed.

Partner across Rockstar. You'll work closely with the VA operations team, sales, and leadership to make sure credentialing fits into the broader partner experience, not as a bolt-on service but as a core part of what makes Rockstar different.



Requirements

  • 4+ years in provider credentialing, payer enrollment, or medical staff services, ideally with direct experience in a multi-location or multi-payer environment

  • Real, hands-on knowledge of CAQH ProView, PECOS, and payer-specific credentialing requirements (Medicare, Medicaid, and major commercial payers)

  • Experience managing re-credentialing cycles and ongoing compliance monitoring, not just initial applications

  • A track record of building or significantly improving a process, not just running one someone else designed

  • Team leadership experience, or clear readiness to hire and manage a growing team

  • Comfort with ambiguity. This is a new service line. You'll be making calls without a precedent to point to

  • Sharp attention to detail. A missed field on a CAQH profile can cost a practice weeks of revenue

  • Experience in PT, OT, or SLP credentialing is a strong plus, but not required

Why This Role


You're not joining an existing team to maintain what's already built. You're building the thing. If credentialing gets done well, practices get paid faster, providers see patients sooner, and Rockstar becomes the partner practices can't imagine running without. That's the job.



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.



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