Provider Data Specialist - 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 17 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
& Performance.
Expanding
access to affordable, high quality health care starts here. This is
where some of the most innovative ideas in health care are created every
day. This is where bold people with big ideas are writing the next
chapter in health care. This is the place to do your life's best work.The Provider Data Specialist
is responsible for various activities related to the Provider Network
database which may include any or all of the following: database
maintenance, reporting and extracting data for various reports and
analyses, and initiating database improvement. Provider Data Specialists
develop and maintain standards for database integrity and quality
assurance, coordinate corrective activities to clean database and retain
users, and manage communication processes with other departments
regarding database improvements. Other responsibilities include
conducting audits and providing feedback to reduce errors and improve
processes and performance, maintaining current provider data to ensure
the quality of the network, and may be responsible for representing the
provider network area on company IT projects, reporting and tracking
provider calls and complaints, or for the support, coordination, and
production of the paper directory cycles.Primary Responsibilities:
Maintenance of all provider records
within the health plan system(s). Includes setup of demographic and
specialty information, panel information (if applicable), line of
business and fee schedule as instructedAssists in ensuring that Provider
Directories and regulatory requirements are accurate and that errors are
root caused and discussed at the global level to ensure appropriate
corrections and improvements are madeData integrity and quality assuranceRequests for new or updates to provider records must completed within business mandated service level agreementsOther assignments and projects as requestedSolve routine problems on ownWork with supervisor to solve more complex problems

Required Qualifications:
High School Diploma or GED2+ years of Customer Service experience1+ years of Data Entry experienceStrong knowledge of standard PC packages (Microsoft Word, Excel and Outlook)Ability to type at least 50 WPMPreferred Qualifications:
1+ years of previous experience in a healthcare setting particularly with managed care systemsKnowledge of Medicaid / Medicare / Commercial rules and regulationsPrevious experience working in a production and quality environmentAbility to utilize complex database
systems and claims platforms simultaneously including, but not limited
to OHBS and CSP Facets, COSMOS, and NDBSoft Skills:
Strong research, follow-up, documentation, and issue resolution skillsStrong root cause analysis skills
including the ability to take complex matters and format simplified key
concepts to provide clear guidance to internal customersExperience multi-tasking and applying attention to detailAbility to work independently and as a team playerExcellent written and verbal communication skillsSolid analytical and problem-solving skills using reasoning and available resources to resolve issuesIndependently prioritize and organize own work to complete daily tasks within required business mandated time-framesAbility to think independently and is not afraid to ask questions with the goal of continuous improvement in mindAbility to effectively adapt and adjust to changing business needs Careers 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.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: UnitedHealth Group, Eden Prairie, Data Entry, Claims, Customer Service, audits, reports, CSP Facets, COSMOS, NDB