Credentialing Representative

UnitedHealth Group•El Segundo, CA

2d•$18 - $32•Remote

About The Position

The Credentialing Representative supports provider credentialing across multiple markets by managing end-to-end data entry, provider file preparation and system loading within MD Staff and related credentialing platforms. The position conducts audits, identifying process improvements and independently resolving complex issues. The role plays a critical part in ensuring accurate, compliant credentialing operations. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Requirements

High School Diploma/GED
3+ years of healthcare provider credentialing experience
1+ years of experience working with compliance workflows and processes, including NCQA policies and practices
1+ years of experience in researching and applying government regulatory information
Intermediate level of proficiency with MS Excel and Word
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Responsibilities

Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system
Conduct audits and provide feedback to reduce errors and improve processes and performance
Apply knowledge/skills to a range of moderately complex activities
Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others