Senior Team Leader – Provider Credentialing & Enrollment
Department: Credentialing / Provider Enrollment
Experience: 6–10 Years
Location: Chennai
Employment Type: Full time
Shift: US Shift / Night Shift
Position Summary
We are looking for an experienced Senior Team Leader – Provider Credentialing & Enrollment to lead a team handling end-to-end US healthcare provider credentialing and payer enrollment activities. The role will be responsible for team performance, quality, SLA/TAT, escalations, provider enrollment, recredentialing, payer follow-ups, and stakeholder management.
Key Responsibilities
Lead, mentor and manage a team of Provider Credentialing / Enrollment Specialists and ensure achievement of productivity, quality and SLA targets.
Oversee end-to-end provider credentialing, recredentialing, enrollment, revalidation, demographic updates and terminations .
Manage credentialing and enrollment activities for individual providers, group practices and multiple specialties .
Ensure accurate and timely processing through CAQH, PECOS, NPPES/NPI, Medicaid and commercial payer portals .
Handle Medicare, Medicaid, Commercial, HMO/IPA and Managed Care payer enrollment activities.
Review applications and provider documentation for completeness, accuracy and payer-specific requirements.
Monitor application aging, pending cases, rejections, follow-ups, expirables and enrollment effective dates.
Act as the first-level escalation point for complex credentialing and payer enrollment issues.
Coordinate with US-based providers, clients,



payer representatives and internal stakeholders to resolve issues and meet deadlines.
Conduct quality audits, identify process gaps and implement corrective actions to improve accuracy and TAT.
Prepare and publish MIS/KPI reports covering productivity, quality, aging, TAT and SLA performance.
Train and coach team members on payer requirements, credentialing processes, portals and SOP updates.
Identify opportunities for process improvement, standardization and automation .
Required Skills & Experience
6–10 years of experience in US Healthcare Provider Credentialing / Provider Enrollment.
Minimum 2–3 years of experience in Team Lead / Senior Team Lead / supervisory role .
Strong provider-side experience; candidates with only payer-side credentialing experience are not preferred.
Hands-on experience with CAQH ProView, PECOS, NPPES/NPI, Medicare, Medicaid and Commercial payer portals .
Strong understanding of provider documentation, licenses, DEA, board certification, malpractice insurance, taxonomy and revalidation.
Experience managing team KPIs, SLA, productivity, quality and TAT .
Strong escalation handling, problem-solving and stakeholder management skills.
Excellent verbal and written communication skills with the ability to interact with US-based clients/providers .
Experience in a Healthcare BPO / RCM / shared-services environment will be preferred.
Good knowledge of MS Excel, reporting and credentialing trackers .
Education
Bachelor’s Degree Business Administration or any relevant discipline preferred.

📌 Senior Team Leader _ Provider Enrollment (Chennai)
🏢 Saisystems Health
📍 Chennai