Credentialing & Provider Enrollment Specialist

Commonwealth of Massachusetts; Tewksbury Junction (MA); On-site; USD 58,000 - 82,000; Full time

Job summary

Massachusetts Department of Public Health is seeking an Office Support Specialist I at Tewksbury Hospital to oversee professional credentialing activities, enrollment in CMS/PECOS, and MassHealth coordination. The role supports provider data, document management, and enrollment workflows in a Monday–Friday schedule.

The ideal candidate has strong communication and multitasking skills, customer-service mindset, and proficiency with standard office software.

Qualifications

• 2 years of full-time administrative work experience or equivalent
• Substitutions allow an Associate's or higher degree to replace up to two years of experience
• Educational substitutions limited to two years of required experience
• Salary placement per HR guidelines and bargaining unit agreements

Responsibilities

• Create and maintain provider enrollment accounts (CMS-855I, CMS-855R)
• Set up provider access and enrollment in CMS/PECOS
• Enter and maintain provider demographics and practice locations
• Process reassignment of benefits to the appropriate group
• Upload and maintain credentialing/enrollment documents
• Coordinate enrollment approvals and signatures
• Collaborate with Fiscal/Billing for enrollment and payer compliance
• Coordinate MassHealth enrollment for ORP providers
• Monitor five-year revalidation for enrollments
• Track application status and resolve CMS/MassHealth issues
• Offboard departing clinicians and update enrollments
• Maintain accurate provider enrollment records
• Assist with scheduling for the Department of Medicine
• Take minutes at meetings

Skills

Effective communication

Multitasking

Customer service

Software proficiency

Education

Associate's degree or higher in business/related

Tools

Desktop publishing

Project management

Spreadsheets

Database management

Job description

Massachusetts Department of Public Health is seeking an Office Support Specialist I at Tewksbury Hospital to oversee professional credentialing activities, enrollment in CMS/PECOS, and MassHealth coordination. The role supports provider data, document management, and enrollment workflows in a Monday–Friday schedule.

The ideal candidate has strong communication and multitasking skills, customer-service mindset, and proficiency with standard office software.