Provider Credentialing & Enrollment Specialist I

TSG Resources, Inc.; United States; On-site; USD 18,000 - 26,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) plan with company match

Paid time off and holidays

Professional development support

Employee wellness resources

Job summary

SCP Health is seeking a Provider Enrollment Specialist to manage enrollment and re-enrollment for Medicare, Medicaid, BCBS and Commercial payors. You will handle CAQH data, verify credentials, and ensure timely submissions while coordinating with payors and providers in Lafayette, LA.

The role requires attention to detail, ability to manage multiple enrollments, and strong communication with providers and payors. A solid background in credentialing and CMS guidelines is preferred.

Qualifications

• HS Diploma required.
• 2 years college or equivalent experience preferred.
• Minimum 3 years of Provider Enrollment/Payor Credentialing experience required.

Responsibilities

• Process and maintain provider enrollment for Medicare, Medicaid, BCBS and/or Commercial payors.
• Prioritize and manage multiple enrollments in a deadline-driven environment.
• Update and maintain provider credentials to ensure active status.
• Enter enrollment data in Provider database and follow up on submissions.
• Monitor payor requirements and communicate changes to management.

Skills

Payor Credentialing

CAQH

National Provider Identifier

Provider Enrollment

Microsoft Office

Education

HS Diploma or equivalent

2 years college experience

Tools

CAQH database

Availity

Credentialing software

CMS regulations knowledge

Job description

SCP Health is seeking a Provider Enrollment Specialist to manage enrollment and re-enrollment for Medicare, Medicaid, BCBS and Commercial payors. You will handle CAQH data, verify credentials, and ensure timely submissions while coordinating with payors and providers in Lafayette, LA.

The role requires attention to detail, ability to manage multiple enrollments, and strong communication with providers and payors. A solid background in credentialing and CMS guidelines is preferred.