Credentialing Representative - Eden Prairie, MN

Position Description:
 


Energize your career with one of Healthcare’s fastest growing
companies.  

 

You dream of a great career with a great company - where you can
make an impact and help people.  We dream of giving you the opportunity to
do just this.  And with the incredible growth of our business, it’s a
dream that definitely can come true. Already one of the world’s leading
Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to
operate our Service Centers, improve our Service levels and help people lead
healthier lives. We live for the opportunity to make a difference and right
now, we are living it up.

 

This opportunity is with one of our most exciting business areas:
Optum - a growing part of our family of companies that make UnitedHealth Group
a Fortune 14 leader.

 

Optum helps nearly 60 million Americans live their lives to the
fullest by educating them about their symptoms, conditions, and treatments;
helping them to navigate the system, finance their Healthcare needs, and stay
on track with their Health goals. No other business touches so many lives in
such a positive way. And we do it all with every action focused on our shared
values of Integrity, Compassion, Relationships, Innovation, and Performance.


The Credentialing Representative
is responsible for activities associated with credentialing or
re-credentialing physicians and providers, including processing provider
applications and re-applications including initial mailing, review, and
loading into the database tracking system ensuring high quality
standards are maintained. Credentialing Representatives will assist with audits and provide feedback to reduce errors and improve processes and performance. Employees
in jobs labeled with SCA must support a government Service Contract Act
(SCA) agreement.Primary Responsibilities:

Apply knowledge/skills to a range of moderately complex activities.
Demonstrate great depth of knowledge/skills in own function.
Sometimes act as a technical resource to others in own function.
Proactively identify solutions to non-standard requests.
Solve moderately complex problems on own.
Work with team to solve complex problems.
Plan, prioritize, organize and complete work to meet established objectives.
May coordinate work of other team members.
Credentialing of physical health providers
Extensive work experience within own function.
Work is frequently completed without established procedures.
Works independently.
May act as a resource for others.
May coordinate others activities.

Required Qualifications:

High School Diploma or GED
1+ year of Healthcare Provider Credentialing experience
Experience in researching and applying Government Regulatory Information
Intermediate level of proficiency with Microsoft Excel and Word
Intermediate level of proficiency with Adobe
Assets:Experience working with Compliance Workflows and Processes including NCQA Policies and PracticesCareers with Optum.
Here's the idea. We built an entire organization around one giant
objective; make the health system work better for everyone. So when it
comes to how we use the world's large accumulation of health-related
information, or guide health and lifestyle choices or manage pharmacy
benefits for millions, our first goal is to leap beyond the status quo
and uncover new ways to serve. Optum, part of the UnitedHealth Group
family of businesses, brings together some of the greatest minds and
most advanced ideas on where health care has to go in order to reach its
fullest potential. For you, that means working on high performance
teams against sophisticated challenges that matter. Optum, incredible
ideas in one incredible company and a singular opportunity to do your life's best work.SM
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer
and all qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, age, national origin,
protected veteran status, disability status, sexual orientation, gender
identity or expression, marital status, genetic information, or any
other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: customer service, claims, healthcare, UnitedHealthcare, UnitedHealth Group.