At SCP Health, what you do matters As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care. Why you will love working here: - Strong track record of providing excellent work/life balance. - Comprehensive benefits package and competitive compensation. - Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect. Primary Duties and Responsibilities: • Process and maintain provider applications for enrollment and re-enrollment for Medicare, Medicaid, BCBS and/or 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, i.e. Medical License, DEA to ensure they are active and in good standing. • Submit updated credentials to payors when credentials have expired to ensure no lapse in enrollment. • Serve as the primary contact for providers and payors when questions regarding enrollment/re-enrollment arise. • Identify any issues with providers eligibility to participate in Government plans. • Advise Supervisor/Manager immediately of any eligibility issues for providers. • Procure all documents needed from Provider to enroll timely. Escalate to MSL on non-response providers. • Perform data entry of submitted applications in Provider database record along with any documentation related to the enrollment process. • Perform follow up on submissions via online, email or phone according to policies and procedures to ensure timely approval is received. • Maintain accurate database information and perform data quality cleanup activities as directed by Management. • Maintain confidentiality of privileged information. • Work in CAQH database and maintain/update providers’ credentials every 90 days. • On occasion, may be required to be onsite at client facility to distribute PEPs and help facilitate in person enrollment. • Once approval is received from payors, document approval and effective dates in Provider Enrollment system to ensure approvals and information are pushed to Billing System for release of claims. • Monitor changes to payor requirements through payor websites, bulletins, emails, etc and communicate any changes to appropriate Managers to ensure changes are made wherever applicable. Required Skills and Qualifications: • Work independently utilizing documented processes and automated daily reports generated from database. • When payor requirements change, must be able to analyze and compare processes in order to recommend process solutions to Management. • Agility in managing multiple priorities with strong organizational and time management skills. • Knowledge of Payor Credentialing processes, both Par and Non-Par. • Knowledge of Provider Credentials. • Experience working in CAQH database and National Provider Identifier database • Knowledge of CMS Regulations and guidelines. • Proficient 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 both orally and in writing. • Minimum 3 years of Provider Enrollment/Payor Credentialing experience required. Preferred Skills and Qualifications: • Experience with Availity and other provider related credentialing/enrollment databases. • Experience working with Medicare, Medicaid or any Commercial payor. • Experience working with Credentialing/Enrollment software. EDUCATION: • HS Diploma required. • 2 years college or equivalent experience preferred. FIELD OF STUDY: • Healthcare Administration • Business Administration CERTIFICATES AND LICENSES: (Preferred) • PESC (Provider Enrollment Specialist Certificate) • CPCS (Certified Provider Credentialing Specialist) PRIMARY LOCATION: • Lafayette, LA Pay Range: 13.00 - 19.00 USD per hour This range represents the anticipated base salary for this role. Actual compensation will be determined based on experience, qualifications, and internal equity considerations. - We offer a comprehensive benefits package designed to support your health, financial well-being, and work-life balance, including medical dental, vision insurance, a 401(k) plan with a company match, paid time off and holidays, professional development support, and employee wellness resources. Visit our website for further information. https://myscpbenefits.com/ Login name: corp-guest Password: weheal