Full-Time
Provider Enrollment Specialist
Posted on 9/4/2026
SCP Health
Compensation Overview
$13 - $19/hr
Lafayette, LA, USA
In Person
Occasional on-site visits to a client facility may be required.
Category
 Medical, Clinical & Veterinary (1) |
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Required Skills
Microsoft Office
Word/Pages/Docs
Excel/Numbers/Sheets
Requirements
- Work independently using documented processes and automated daily reports generated from a database.
- Analyze and compare processes when payor requirements change and recommend process solutions to management.
- Manage multiple priorities with organizational and time-management skills.
- Knowledge of payor credentialing processes, including participating and non-participating processes.
- Knowledge of provider credentials.
- Experience working with the Council for Affordable Quality Healthcare database and National Provider Identifier database.
- Knowledge of Centers for Medicare & Medicaid Services regulations and guidelines.
- Proficiency in Microsoft Office applications, including Word and Excel.
- Ability to foster a cooperative and respectful work environment.
- Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
- Ability to communicate effectively orally and in writing.
- Minimum three years of provider enrollment or payor credentialing experience.
- A high school diploma is required.
Responsibilities
- Process and maintain provider applications for enrollment and re-enrollment for Medicare, Medicaid, Blue Cross Blue Shield, and commercial payors in accordance with federal and state guidelines.
- Prioritize and manage multiple enrollments in a deadline-driven environment.
- Distribute, log, receive, and scan provider enrollment packets as assigned.
- Update National Provider Database information as needed.
- Monitor credentials, including medical licenses and Drug Enforcement Administration credentials, to ensure they are active and in good standing.
- Submit updated credentials to payors when credentials have expired to prevent lapses in enrollment.
- Serve as the primary contact for providers and payors regarding enrollment and re-enrollment questions.
- Identify issues affecting providers' eligibility to participate in government plans.
- Advise the supervisor or manager immediately of provider eligibility issues.
- Obtain all documents needed from providers for timely enrollment and escalate nonresponsive providers to the Medical Staff Liaison.
- Enter submitted applications and related documentation into provider database records.
- Follow up on submissions online, by email, or by phone according to policies and procedures to ensure timely approval.
- Maintain accurate database information and perform data-quality cleanup activities as directed by management.
- Maintain confidentiality of privileged information.
- Work in the Council for Affordable Quality Healthcare database and update providers' credentials every 90 days.
- On occasion, attend a client facility to distribute provider enrollment packets and help facilitate in-person enrollment.
- Document payer approvals and effective dates in the provider enrollment system so approvals and information are pushed to the billing system for claims release.
- Monitor changes to payor requirements through payor websites, bulletins, and emails, and communicate applicable changes to managers.
Desired Qualifications
- Experience with Availity and other provider-related credentialing and enrollment databases.
- Experience working with Medicare, Medicaid, or commercial payors.
- Experience working with credentialing or enrollment software.
- Two years of college or equivalent experience.
- Provider Enrollment Specialist Certificate.
- Certified Provider Credentialing Specialist certification.