Senior Provider Enrollment Representative

UnitedHealth Group•Fremont, CA

3d•$20 - $36•Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Provider Enrollment Representative is responsible for preparing, submitting and maintaining provider and group enrollment applications while ensuring accuracy and compliance with NCQA, CMS and state regulatory standards. Get ready for some significant challenge. 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 Schedule: Monday to Friday, 8 AM- 5 PM, EST or CST Location: Remote - Nationwide You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Requirements

High School Diploma/GED (or higher)
5+ years of experience in completing and submitting 10-15 behavioral health commercial/government provider enrollment applications
5+ years of experience submitting with follow ups and issue resolution
2+ years of experience with completing and submitting provider enrollment applications for Medicare/Medicaid
2+ years of experience working with compliance workflows and processes, including NCQA policies and practices
2+ years of experience in researching and applying government regulatory information
Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
Ability to work a 40-hour work week from 8:00 am to 5:00 pm EST or CST
Ability to be on camera during Microsoft Teams meetings

Nice To Haves

Extensive knowledge of commercial, Medicaid, and Medicare provider enrollment applications
Intermediate level of proficiency with MS Excel and Word
Effective time management and ability to multi-task
Demonstrated ability to successfully work in a production environment
Keen attention to detail
Self-starter
Ability to work independently and as a team

Responsibilities

Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system
Submit 10 to 15 provider enrollment applications
Prepare, process, and maintain new provider and group enrollments
Conduct audits and provide feedback to reduce errors and improve processes and performance
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
Initiate and assist with developments/changes to increase or change quality and productivity
Act as a facilitator to resolve conflicts on team
Perform as key team member on project teams spanning more than own function