Provider Enrollment Specialist

SCP Health

Provider enrollment specialist managing Medicare, Medicaid, and commercial payor credentialing for SCP Health. Maintaining provider credentials, applications, databases, and enrollment approvals.

Posted 8/17/2026full-timeLafayette • Louisiana • 🇺🇸 United StatesMid-LevelSenior💰 $15 - $21 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Provider Enrollment and Payor Credentialing processes, including proficiency in CAQH and National Provider Identifier databases. Strong organizational skills and the ability to analyze and adapt to changing payor requirements are essential.

Highest-signal resume keywords

Provider Enrollment ExperiencePayor Credentialing KnowledgeCAQH Database ProficiencyCMS Regulations KnowledgeStrong Organizational Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Provider CredentialingEnrollment DocumentationData Quality CleanupPayor Requirement AnalysisDatabase Management

Soft Skills

Strong Interpersonal SkillsTime ManagementCritical ThinkingEffective Communication

Tools & Technologies

Microsoft WordMicrosoft ExcelAvailityProvider Enrollment Databases

Certifications & Qualifications

PESC CertificationCPCS Certification

Industry Keywords

MedicareMedicaidCommercial PayorsProvider Enrollment PacketsNational Provider Database

About the role

Key responsibilities & impact

Process and maintain provider applications for enrollment and re-enrollment for 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 and maintain provider credentials
Monitor medical licenses and DEA credentials to ensure they remain active and in good standing
Serve as the 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-responsive providers
Enter applications 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 the CAQH database 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 managers

Requirements

What you’ll need

Minimum 3 years of Provider Enrollment/Payor Credentialing experience required
Ability to work independently with little or no oversight
Ability to analyze changed payor requirements and recommend process solutions
Strong organizational and time management skills
Knowledge of Payor Credentialing processes, both Par and Non-Par
Knowledge of Provider Credentials
Experience working in CAQH and National Provider Identifier databases
Knowledge of CMS Regulations and guidelines
Proficiency in Microsoft Word and Excel
Strong interpersonal, oral, and written communication skills
Ability to work effectively with diverse constituencies
High school diploma required
PESC and CPCS certifications preferred
Experience with Availity and other provider credentialing/enrollment databases preferred
Experience with Medicare, Medicaid, or Commercial payors preferred
Experience with credentialing/enrollment software 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 a company match
Paid time off and holidays
Professional development support
Employee wellness resources