Credentialing Representative

UnitedHealth Group • Eden Prairie, MN

16h • $18 - $32 • Remote

About The Position

Optum is seeking a Credentialing Representative to enroll behavioral health providers with appropriate payers. This role is crucial in connecting people with the care, pharmacy benefits, data, and resources they need to live healthier lives. The position offers a culture of diversity and inclusion, opportunities for collaboration with talented peers, comprehensive benefits, and career development. The work directly impacts communities by advancing health equity on a global scale.

Requirements

• High School Diploma/GED
• 1+ years of healthcare customer service and/or administration experience
• 1+ years of healthcare provider credentialing experience
• Intermediate level of proficiency with Microsoft Excel and Microsoft Word
• Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
• Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Nice To Haves

• Experience working with compliance workflows and processes, including NCQA policies and practices
• Experience researching and applying government regulatory information
• Ability to work independently and as a team, and maintain good judgment and accountability
• Demonstrated ability to work well with health care providers and team members
• Strong organizational and time management skills
• Ability to multi-task and prioritize tasks to meet all deadlines
• Ability to work well under pressure in a fast-paced environment
• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others

Responsibilities

• Process provider applications and re-applications including initial communications, verifications, review and loading into the databases
• Conduct quality audits and provide feedback to reduce errors and improve processes and performance
• Solve complex problems independently and proactively identify new solutions
• Apply knowledge and skills to a range of moderately complex activities
• Demonstrate in-depth knowledge and skills in own function and serve as an information resource to others
• Perform data analysis from multiple sources
• Prioritize daily responsibilities
• Confirm to exacting standards such as NCQA, CMS and state credentialing requirements
• Perform other duties as assigned

Benefits

• Paid Time Off which you start to accrue with your first pay period
• 8 Paid Holidays
• Medical Plan options
• Participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life & AD&D Insurance
• Short-term disability and Long-term disability coverage
• 401(k) Savings Plan
• Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED