We’ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas®.

Job Summary
The Enrollment Specialist facilitates the payer applications from a new/existing provider through all stages in order to enroll or re-validate the providers with commercial, delegated and government payers. This position is responsible for updating practitioner information in both the internal software and with external payers. In addition to data entry, the specialist also maintains copies of licensure, certificates, and other documents necessary for the enrollment process, maintains provider CAQH profiles, and conducts verification of all data, ensuring accuracy and timely entry of information.

Reports to
Senior Operations Manager

Job Specific Responsibilities
1. Conducts the enrollment process and maintains accurate and up to date provider information in CredentialStream platform and Teams software.
2. Adheres to deadlines and enrollment schedules by tracking enrollment through all stages.
3. Helps the department transition to digitized workflows.
4. Maintains confidentiality and responsibility for all enrollment files through the process.
5. Maintains an organized database of physician information, ensuring accuracy and completeness.
6. Ensures that all enrollment activities adhere to healthcare regulations, best practices and organizational policies.
7. Collaborates with UMCP, UMC departments and billing to facilitate the enrollment process.
8. Addresses and resolves enrollment-related issues and discrepancies promptly.
9. Generates reports and documentation related to physician enrollment, as needed.
10. Maintains workflows for provider enrollment within CredentialStream platform.
11. Shares essential updates with providers and the internal team as necessary.

Education and Experience
• High School Diploma or GED
• At least 2 years related experience and/or training is preferred.

Required Licensures/Certifications/Registrations
• N/A

Knowledge, Skills and Abilities
• Basic knowledge of medical credentialing and privileging procedures.
• Must be able to multi-task.
• Proficiency in Microsoft Office.

Interaction with Other Departments and Other Relationships
Internal: Interacts with providers, payers, UMC Medical Staff Office and UMC Managed Care via email, phone, and mail.

Physical Capabilities
Position requires prolonged periods of sitting at a desk, talking on a phone, and working on a computer. Essential hearing and near vision acuity required. Should be able to lift up to 20 pounds, push, pull, and stooping required at times.

Environmental/Working Conditions
Work area is in an office environment, well lit, and subject to varying indoor temperatures

Direct Reports
None

UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

*Request for accommodations in the hire process should be directed to UMC Human Resources.​*