The University of Texas Rio Grande Valley
PROVIDER ENROLLMENT SPECIALIST
Edtech.com's Summary
- Coordinate all aspects of provider enrollment, including initial enrollment, re-enrollment, and monitoring to ensure proper billing and collections.
- Prepare enrollment applications for health plans such as Medicare and Medicaid.
- Maintain timelines and escalate delays in enrollment processes.
- Provide monthly updates on provider status changes to contracted plans.
- Assist with resolving provider-related denials and payor issues to ensure proper reimbursement.
- Respond to internal and external inquiries on enrollment and contract matters.
- Supervise assigned staff and perform special projects as needed.
- Requires Associate's degree in Business Administration or related field with three years of relevant experience, or five years with a high school diploma.
- Preferred experience includes knowledge of MD Staff and CAQH systems.
- Compensation is commensurate with experience.
PROVIDER ENROLLMENT SPECIALIST Full Description
Office Location
The University of Texas Rio Grande Valley
1201 W. University Drive
Human Resources
MASS Building 2nd Floor
Edinburg, TX 78539
Edinburg: (956)665-2451
Brownsville: (956) 882-8205
Office hours:
Monday-Friday
8:00a.m. - 5:00p.m.
Staff Recruitment: careers@utrgv.edu
School of Medicine Recruitment: SOMCareers@utrgv.edu
Graduate Assistantships: assistantships@utrgv.edu
Faculty Recruitment:
College of Engineering & Computer Science: cecs@utrgv.edu
Robert C. Vackar College of Business & Entrepreneurship: cobe@utrgv.edu
College of Sciences Office of the Dean: cos@utrgv.edu
College of Education and P-16 Integration: cep@utrgv.edu
College of Fine Arts: cofa@utrgv.edu
College of Liberal Arts: liberalarts@utrgv.edu
Website: https://careers.utrgv.edu
Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening. To apply for the position, please click the Apply for this Job link/button.
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| Posting Number | SRGV8939 |
|---|---|
| Working Title | PROVIDER ENROLLMENT SPECIALIST |
| Number of Vacancies | 1 |
| Location | Harlingen, Texas |
| Department | School of Medicine/ Revenue Cycle |
| FTE | 1.0 |
| FLSA | Non-Exempt |
| Scope of Job | Coordinate, monitor and maintain the provider enrollment and re-enrollment processes in a timely and compliant manner with all government and commercial payors. |
| Description of Duties | • Facilitates all aspects of provider enrollment, including initial enrollment, re-enrollment, and monitoring of all providers to ensure proper and timely billing and collections. • Prepares enrollment applications for all health plans including Medicare and Medicaid. • Maintains timelines on enrollment processes and address and/or escalate any delays. • Ensures that all pending enrollments are reviewed, obtained and managed according to the rules and policies of the department. • Provides monthly notification of new providers, resignations and changes in provider status such as practice locations and panel status to contracted plans. • Follows up with necessary contacts, including providers and managed care organizations, to resolve enrollment application issues and deficiencies. • Assists with resolution of provider related denials to ensure appeal procedures are followed to result in proper reimbursement. • Assists with problem identification and timely resolution of payor related issues. • Responds to internal and external inquiries on routine enrollment and contract matters, as appropriate. • Performs detailed follow-up activities on assigned accounts according to procedures. • Maintains confidentiality of all provider enrollment business/work and medical staff information. • Participates in special projects/assignments. • Performs other duties as assigned. |
| Supervision Received | General supervision from assigned supervisor. |
| Supervision Given | Direct supervision of assigned staff. |
| Required Education | Associates degree in Business Administration or closely related field. |
| Preferred Education | N/A |
| Licenses/Certifications | None. |
| Required Experience | • Three (3) years of financial, credentialing, billing or related experience in a healthcare organization, or • Five (5) years of the required experience with a High School Diploma. |
| Preferred Experience | Experience in MD Staff and CAQH (Council for Affordable Quality Healthcare) |
| Equipment | Use of standard office equipment. |
| Working Conditions | Needs to be able to successfully perform all required duties. Office Environment; some travel to clinic sites to obtain enrollment documentation and weekend work may be required. |
| Other | Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. |
| Physical Capabilities | N/A |
| Employment Category | Full-Time |
| Minimum Salary | Commensurate with Experience |
| Posted Salary | Commensurate with Experience |
| Position Available Date | 05/18/2026 |
| Grant Funded Position | No |
| If Yes, Provide Grant Expiration Date |
| EEO Statement | It is the policy of The University of Texas Rio Grande Valley to promote and ensure equal employment opportunities for all individuals without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or protected veteran status. In accordance with the requirements of Title VII of the Civil Rights Act of 1964, the Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990, as amended, our University is committed to comply with all government requirements and ensures non-discrimination in its education programs and activities, including employment. We encourage women, minorities and differently abled persons to apply for employment positions of interest. |
|---|---|
| Special Instructions to Applicants | Dear Applicant, Human Resources will not be held responsible for redacting any confidential information from the documents you attach with your application. The confidential information includes the following: *Date of Birth *Social Security Number *Gender *Ethnicity/Race Please make sure that you omit this information prior to submission. We are advising that Human Resources will be forwarding your application to the department as per your submission. If you have any questions, please visit our Careers site at https://careers.utrgv.edu for detailed contact information. |
| Additional Information |
UTRGV is a distributed location institution and working location is subject to change based on need. All UTRGV employees are required to have a criminal background check (CBC). Incomplete applications will not be considered. Substitutions to the above requirements must have prior approval from the VP of HR & Regulatory Affairs. |
| Quick Link | https://careers.utrgv.edu/postings/50971 |
Required fields are indicated with an asterisk (*).
- *
Are you now, or previously, employed by The University of Texas System or any of its institutions?
- Yes - I currently am employed by the UT System or its institutions
- Yes - I have previously been employed by the UT System or its institutions
- No - I have never been employed by the UT System or its institutions
- *
Are you a current UTRGV employee?
- Yes
- No
- *
Please select your highest level of completed education.
- 6th grade education
- 10th grade education
- High School Diploma or GED
- Associates Degree, Technical, or Trade School Degree/Certification or 60 Hours of College Hours
- Bachelors Degree from an accredited university
- Masters Degree from an accredited university
- Ph. D. or other terminal degree from an accredited university
- None of the above
- *
Please provide the field of study for your education:
(Open Ended Question)
- *
Please indicate the number of years of work experience you have directly related to the position in which you are applying for:
- Less than 1 year
- 1 year
- 2 years
- 3 years
- 4 years
- 5 years
- 6 years
- 7 years
- 8 years
- 9 years
- 10 years
- Over 10 years
- *
Do you meet the minimum requirements for this position?
- Yes
- No
- Resume
Optional Documents
- Cover Letter/Letter of Application
- Unofficial Transcripts
- Reference Letter 1
- Reference Letter 2
- Reference Letter 3
- Certifications and Licenses
- Training Certificates
- Other Document
- List of 3 References
- Unofficial Transcripts 2
- Unofficial Transcripts 3
- Letter of Interest
- Unofficial Graduate Transcripts
- Additional Document
.
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