Senior Team Leader – Provider Credentialing & Enrollment

nDepartment: Credentialing / Provider Enrollment

nExperience: 6–10 Years

nLocation: Chennai

nEmployment Type: Full-Time

nShift: US Shift / Night Shift

nPosition Summary

nWe 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.

nKey Responsibilities

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- Lead, mentor and manage a team of Provider Credentialing / Enrollment Specialists and ensure achievement of productivity, quality and SLA targets.
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- Oversee end-to-end provider credentialing, recredentialing, enrollment, revalidation, demographic updates and terminations.
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- Manage credentialing and enrollment activities for individual providers, group practices and multiple specialties.
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- Ensure accurate and timely processing through CAQH, PECOS, NPPES/NPI, Medicaid and commercial payer portals.
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- Handle Medicare, Medicaid, Commercial, HMO/IPA and Managed Care payer enrollment activities.
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- Review applications and provider documentation for completeness, accuracy and payer-specific requirements.
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- Monitor application aging, pending cases, rejections, follow-ups, expirables and enrollment effective dates.
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- Act as the first-level escalation point for complex credentialing and payer enrollment issues.
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- Coordinate with US-based providers, clients,



payer representatives and internal stakeholders to resolve issues and meet deadlines.
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- Conduct quality audits, identify process gaps and implement corrective actions to improve accuracy and TAT.
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- Prepare and publish MIS/KPI reports covering productivity, quality, aging, TAT and SLA performance.
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- Train and coach team members on payer requirements, credentialing processes, portals and SOP updates.
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- Identify opportunities for process improvement, standardization and automation.
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nRequired Skills & Experience

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- 6–10 years of experience in US Healthcare Provider Credentialing / Provider Enrollment.
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- Minimum 2–3 years of experience in Team Lead / Senior Team Lead / supervisory role.
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- Robust provider-side experience; candidates with only payer-side credentialing experience are not preferred.
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- Hands-on experience with CAQH ProView, PECOS, NPPES/NPI, Medicare, Medicaid and Commercial payer portals.
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- Strong understanding of provider documentation, licenses, DEA, board certification, malpractice insurance, taxonomy and revalidation.
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- Experience managing team KPIs, SLA, productivity, quality and TAT.
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- Strong escalation handling, problem-solving and stakeholder management skills.
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- Excellent verbal and written communication skills with the ability to interact with US-based clients/providers.
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- Experience in a Healthcare BPO / RCM / shared-services environment will be preferred.
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- Good knowledge of MS Excel, reporting and credentialing trackers.
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nEducation

nBachelor's Degree Business Administration or any relevant discipline preferred.

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