Senior Credentialing Representative

UnitedHealth Group•Oklahoma City, OK

6d•$20 - $36•Remote

About The Position

The Senior 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.

Requirements

High School Diploma/GED (or higher)
4+ years of healthcare provider credentialing experience
2+ years of experience working with compliance workflows and processes, including NCQA policies and practices
Intermediate level of proficiency with MS Excel and Word

Nice To Haves

MD Staff software experience
Behavioral health enrollment experience
Prior delegation experience
Multistate enrollment experience

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
Complete delegation rosters accurately with great attention to detail and discernment to ask questions as needed
Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
Solve complex problems on own; proactively identify new solutions to problems
Act as a facilitator to resolve conflicts on team
Perform as key team member on project teams spanning more than own function