Provider Enrollment Specialist at University Physicians' Association – Knoxville, Tennessee

If you’re looking to build a rewarding career in healthcare within a supportive, growth-focused culture, University Physicians’ Association (UPA) would love to have you join our team. We are committed to creating a positive workplace where team members can learn, grow, and succeed—while enjoying a comprehensive and competitive benefits package.

We offer an exceptional benefits package designed to support your professional and personal well-being, including:

• Remote work opportunities
• Flexible scheduling
• Casual work environment
• Paid, on-the-job training
• Medical, Dental, Vision, and Life Insurance
• Short-term & Long-term Disability
• Paid Time Off (PTO), Holiday Pay, and Sick Leave
• Onsite fitness center
• Employee Assistance Program (EAP)
• 401(k) with company match and immediate vesting

This position offers the opportunity to work remotely following a required 90-day on-site training period in Knoxville, TN. Candidates must be able to commute to Knoxville during training.

• Full-time, Monday through Friday
• Typical work hours range between 7:00 a.m. and 5:30 p.m.

• Serve as a liaison between UPA clients and insurance carriers to ensure accurate provider enrollment and resolve large-scale issues
• Track and follow up on provider enrollment applications submitted to payers
• Communicate with payers regarding application status and document updates in the credentialing/enrollment database
• Maintain accurate provider data within UPA’s credentialing software and ensure timely updates with insurance carriers
• Perform quarterly provider data verifications for all UPA clients and as required by individual carriers
• Notify providers of upcoming license or malpractice insurance expirations
• Coordinate provider terminations with UPA providers and the Medical Staff Office as needed
• Participate in payer-delegated credentialing audits in accordance with NCQA requirements
• Attend and actively participate in staff meetings and quality audits
• Assist with the development and implementation of departmental policies, procedures, and forms
• Perform other duties as assigned

• Strong verbal and written communication skills
• Proficiency in Excel
• Excellent organizational skills with a high level of accuracy and attention to detail
• Ability to maintain professionalism and confidentiality
• Working knowledge of CMS, NCQA, and state and federal credentialing regulations
• Ability to multitask and manage complex responsibilities
• Flexible, collaborative, and team-oriented approach
• Self-motivated and able to work independently with minimal supervision
• Proficiency in Word processing and database systems; experience with Cactus preferred
• Ability to work effectively with diverse individuals and under varying circumstances
• Commitment to the values and mission of UPA and the Managed Care Department

• High School Diploma or GED required
• Minimum of two (2) years of experience in a healthcare delivery environment or one (1) to two (2) years of credentialing/enrollment experience