Revenue Cycle Representative (Provider Enrollment) - Training, Operations, and Administrative Support (TOAST) - Patient Financial Services (PFS)

UIOWA•Iowa City, IA

3d•Hybrid

About The Position

University of Iowa Health Care’s Patient Financial Services department is seeking a Provider Enrollment Revenue Cycle Representative (RCR) for its Training, Operations, and Administrative Support (TOAST) division. The role supports revenue cycle operations by coordinating, maintaining, and managing provider enrollment activities with Medicare, Medicaid, and other assigned payer programs. The representative coordinates enrollment processes, maintains accurate records, and ensures compliance with payer and regulatory requirements. The position works with providers, government payer representatives, vendors, and internal stakeholders to facilitate enrollment, resolve complex issues, and support uninterrupted billing and reimbursement. It applies established tools, technology, and operational knowledge to independently analyze and resolve enrollment matters while exercising sound judgment, professionalism, integrity, and commitment to UI Health Care’s Service Excellence standards. The role is eligible for a hybrid work arrangement, with onsite and remote work. Remote work must be performed from an approved offsite location within Iowa. Initial training is onsite at the Health Support Services Building (HSSB) or virtual, as determined by Patient Financial Services leadership. Remote-work eligibility is assessed after successful training and satisfactory job performance. Work arrangements are subject to annual review and applicable university policies. The schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m., at 100% time. The department provides onsite equipment. For offsite work, the employee must provide two monitors, a keyboard, and a mouse at their own expense, and must meet specified home-office and internet-speed verification requirements. A university-issued laptop serves as a third monitor. The position requires a bachelor’s degree or an equivalent combination of education and experience, and at least one year of relevant experience.

Requirements

Bachelor’s degree or equivalent combination of education and experience.
At least one year of experience in a professional, healthcare, revenue cycle, provider enrollment, credentialing, insurance, compliance, or related administrative environment.
Strong attention to detail and ability to analyze information, maintain accurate records, identify discrepancies, and ensure data integrity across multiple systems and databases.
Critical-thinking and problem-solving skills, including the ability to research, interpret, and resolve complex enrollment, billing, or payer-related issues with minimal supervision.
Proficiency with Microsoft Office applications, including Excel, Word, Outlook, and Teams, and ability to learn and apply new software applications and payer systems.
Ability to prioritize work, manage multiple deadlines, and adapt to changing operational needs while maintaining accuracy and productivity.
Strong verbal, written, and interpersonal communication skills and ability to collaborate with providers, leadership, payers, vendors, and internal stakeholders.
Professionalism, initiative, sound judgment, and commitment to high-quality customer service and support in a complex healthcare environment.
For remote work, an approved offsite location within Iowa is required; the employee must provide two monitors, a keyboard, and a mouse at their own expense and meet the specified home-office and internet requirements.

Nice To Haves

Experience with provider enrollment, credentialing, payer contracting support, provider data management, or related healthcare administrative functions.
Knowledge of Medicare, Medicaid, National Provider Identifier (NPI) requirements, provider enrollment regulations, and enrollment processes.
Knowledge of healthcare revenue cycle operations, medical billing, insurance reimbursement, and claims processing.
Experience researching and resolving payer enrollment issues, claim denials, reimbursement delays, or provider data discrepancies.
Experience maintaining productivity and quality standards in a high-volume, deadline-driven environment.
Knowledge of medical terminology, HIPAA requirements, and healthcare regulatory standards.
Experience using Epic, CredentialStream, payer portals, or other healthcare enrollment, credentialing, and patient accounting systems.
Knowledge of Patient Financial Services operations, workflows, and healthcare reimbursement practices.

Responsibilities

Coordinate and manage provider enrollment activities for Medicare, Railroad Medicare, Iowa Medicaid, and other assigned payer programs, including initial enrollments, updates, revalidations, reassignments, terminations, acquisitions, and practice relocations.
Maintain accurate provider records in enrollment databases, payer systems, the NPI Registry, and other organizational applications to meet payer requirements and support uninterrupted billing and reimbursement.
Prepare, submit, track, and maintain enrollment applications and supporting documentation; monitor enrollment status and resolve issues that may affect provider participation or claims processing.
Investigate and resolve provider enrollment-related claim edits, denials, enrollment discrepancies, and reimbursement issues in collaboration with providers, payer representatives, vendors, and internal stakeholders.
Coordinate enrollment activities with providers, clinical departments, the Clinical Staff Office, Patient Financial Services leadership and staff, external vendors, and payer contacts.
Maintain and audit enrollment records, reports, work queues, and vendor activities for accuracy, completeness, regulatory compliance, and adherence to departmental quality standards.
Develop, maintain, and distribute provider enrollment resources, documentation, and communications.
Monitor incoming correspondence, email, and enrollment notifications, and ensure timely review, response, and processing.
Analyze trends, identify process-improvement opportunities, and recommend improvements to leadership.
Support departmental initiatives and special projects while maintaining accuracy, productivity, professionalism, and service excellence.
Protect confidential provider, patient, employee, financial, and organizational information in accordance with applicable laws, regulations, and UI Health Care policies.