Provider Relations Representative

UnitedHealth Group-posted 9 months ago

$59,500 - $116,600/Yr

Full-time • Entry Level

Remote • Grand Junction, CO

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At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The C&S Colorado Provider Relations Representative is responsible for resolving, or coordinating the resolution of, complex provider concerns either via the telephone, email, or occasionally by visiting the provider office. Responsible for providing advanced administrative and technical services that support the provider relations team. This role that will require up to 10% travel throughout the Western and Southern Colorado area. If you are located in Colorado, you will have the flexibility to work remotely as you take on some tough challenges.

Work collaboratively with other provider network staff and various internal and external resources to respond to a variety of complex inquiries related to provider issues.
Triage the inquiry and provide resolution or defer to the appropriate resource.
Serve as a resource for other internal business units or employees working with provider issues.
Maintain comprehensive log of inquiries and visits.
Respect confidentiality and maintain confidences as described in the UHG Employee Handbook.
Receive, research, and process provider questions and issues as assigned.
Process complaints according to the provider complaint administrative denial process and related regulations.
Resolve or coordinate the resolution as appropriate and communicate results back to originating provider.
Track results and identify trends as directed.
Provide training and guidance to providers regarding UHC systems and processes as necessary.
Use excellent interpersonal and communication skills to assist in the resolution of sensitive and complex health plan issues.
Provide administrative and technical services necessary to support the provider relations team.

Requires the combination of education and experience that would enable performance of the full scope of the position.
2+ years of experience with technical health plan processes, such as claims processing and benefits administration.
2+ years of relationship management experience, preferably in a healthcare setting.
Experience and basic proficiency with common programs such as Microsoft Word and Excel.
Demonstrated ability to manage complex business relationships.

2+ years of related progressive experience in a managed care environment.
Excellent written and verbal communication skills.

Comprehensive benefits package.
Incentive and recognition programs.
Equity stock purchase.
401k contribution.

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