Credentialing Lead
RemoteUnited States
Job Summary
Design and launch Rockstar Credentialing workflows, setting quality standards for primary source verification, CAQH management, payer enrollment, and recredentialing cycles. Own end-to-end operations including intake, Medicare/Medicaid enrollment, and ongoing license/sanctions monitoring to ensure accuracy and compliance across all files. Build and scale a team of credentialing specialists while tracking turnaround times and billing privileges for practice partners. Partner with VA operations, sales, and leadership to integrate credentialing as a core service. Manage ambiguity in a new service line with sharp attention to detail to prevent revenue loss from missed steps.
Required Qualifications
- 4+ years in provider credentialing, payer enrollment, or medical staff services
- 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
- A track record of building or significantly improving a process
- Team leadership experience
- Clear readiness to hire and manage a growing team
- Comfort with ambiguity
- Sharp attention to detail
Desired Qualifications
- Experience in PT, OT, or SLP credentialing
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