Description:
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.
Why Join UPA?
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.
Schedule
- Full-time, Monday through Friday
- Typical work hours range between 7:00 a.m. and 5:30 p.m.
Essential Functions
- 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
Competencies
- 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
Requirements:
- 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
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