Job Title: SME Payer Enrollment

Work Mode: Work From Office (WFO)

Location: Chennai

Job Summary

We are seeking a knowledgeable and detail-driven Subject Matter Expert (SME) – Payer Enrollment to support complex provider enrollment functions. The SME will act as the go-to expert for payor enrollment processes, regulations, documentation, and best practices. This role will guide teams, support escalations, ensure compliance, and contribute to process optimization.

Key Responsibilities

- Serve as the primary subject matter expert for all provider enrollment processes, guidelines, and payor-specific requirements.
- Support teams by providing solutions for complex enrollment cases, escalations, and documentation issues.
- Review, validate, and guide the preparation of high-quality enrollment applications for Medicare, Medicaid, and commercial payors.
- Conduct root-cause analysis for rejections, denials, and repeated errors; propose corrective actions.
- Train new and existing team members on payor policies, enrollment workflows, and updated regulations.
- Maintain updated knowledge of CMS, NPPES, PECOS, CAQH, and state-specific enrollment requirements.




- Collaborate with internal teams such as credentialing, operations, and quality to ensure seamless workflows.
- Monitor process performance and share insights on improvements and standardization.
- Prepare and maintain SOPs, checklists, and reference materials for the provider enrollment team.
- Assist leadership with audits, reporting, and special projects related to provider onboarding and data management.

Required Qualifications & Skills

- 4–6 years of experience in US provider enrollment, with deep understanding of Medicare, Medicaid, and commercial payor processes.
- Expertise with enrollment platforms such as PECOS, NPPES, CAQH, Medicaid portals, and commercial payor portals.
- Solid understanding of provider types, taxonomy codes, NPI setups, revalidations, and reassignment workflows.
- Excellent problem-solving skills and ability to explain complex concepts clearly.
- Strong communication, documentation, and stakeholder-facing abilities.
- Proficient in MS Office and enrollment tracking systems.
- Ability to support teams, manage escalations, and handle high-volume tasks efficiently.

📌 SME - Payer Enrollment (Chennai)
🏢 iOpex
📍 Chennai