Provider Enrollment Specialist I

SCP Health

Provider Enrollment Specialist managing Medicare, Medicaid, and commercial payor enrollment for SCP Health, a clinical practice management company. Maintaining provider credentials, applications, databases, and approvals.

Posted 8/11/2026full-timeLafayette • Louisiana • 🇺🇸 United StatesMid-LevelSenior💰 $13 - $19 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Provider Enrollment and Payor Credentialing processes, with a strong focus on managing multiple enrollments and ensuring compliance with CMS regulations. Proficient in utilizing databases such as CAQH and National Provider Identifier for maintaining accurate provider information.

Highest-signal resume keywords

Provider Enrollment ManagementPayor Credentialing ProcessesCAQH Database ProficiencyCMS Regulations KnowledgePESC or CPCS Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider EnrollmentPayor CredentialingData Quality CleanupApplication Documentation EntryMedical License MonitoringDEA Credential MonitoringEnrollment Issue ResolutionOrganizational SkillsTime ManagementCritical Thinking

Soft Skills

Interpersonal CommunicationWritten CommunicationOral CommunicationIndependenceCollaboration

Tools & Technologies

Microsoft WordMicrosoft ExcelAvailityProvider DatabasesBilling System

Certifications & Qualifications

PESC CertificationCPCS Certification

Industry Keywords

MedicareMedicaidCommercial PayorsProvider CredentialsNational Provider DatabaseEnrollment PacketsPayor RequirementsProvider EligibilityCredentialing SoftwareEnrollment Software

About the role

Key responsibilities & impact

Process and maintain provider applications for enrollment and re-enrollment with Medicare, Medicaid, BCBS, and Commercial payors
Prioritize and manage multiple enrollments in a deadline-driven environment
Distribute, log, receive, and scan Provider Enrollment Packets
Update National Provider Database information
Monitor medical licenses and DEA credentials to ensure they are active and in good standing
Serve as primary contact for providers and payors regarding enrollment and re-enrollment
Identify provider eligibility issues for Government plans and advise management
Procure required provider documents and escalate non-responses
Enter application and enrollment documentation into provider databases
Follow up on submissions via online, email, or phone to ensure timely approval
Monitor Provider Enrollment AR on Hold reports and resolve issues
Assist with roster maintenance and training with global partners
Update databases for implementation changes
Solve enrollment-related issues using critical and strategic thinking
Maintain accurate database information and perform data quality cleanup
Maintain confidentiality of privileged information
Work in CAQH and update provider credentials every 90 days
Occasionally be onsite at a client facility to distribute PEPs and facilitate in-person enrollment
Document payor approvals and effective dates so information is pushed to the Billing System
Monitor payor requirement changes and communicate them to management

Requirements

What you’ll need

Work independently with little or no oversight using documented processes and automated database reports
Analyze changed payor requirements and recommend process solutions to Management
Manage multiple priorities with strong organizational and time management skills
Knowledge of payor credentialing processes, both Par and Non-Par
Knowledge of provider credentials
Experience with CAQH and National Provider Identifier databases
Knowledge of CMS regulations and guidelines
Proficiency in Microsoft Word and Excel
Strong interpersonal, written, and oral communication skills
Ability to work effectively with diverse constituencies
Minimum 3 years of Provider Enrollment/Payor Credentialing experience
High school diploma required
Experience with Availity and other credentialing/enrollment databases preferred
Experience with Medicare, Medicaid, or Commercial payors preferred
Experience with credentialing/enrollment software preferred
PESC or CPCS certification preferred

Benefits

Comp & perks

Strong track record of providing excellent work/life balance
Comprehensive benefits package and competitive compensation
Inclusive culture of belonging and empowerment
Medical, dental, and vision insurance
401(k) plan with company match
Paid time off and holidays
Professional development support
Employee wellness resources