Senior Provider Service Representative - US Telecommute - Full-time / Part-time

Position Description:
 
Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

 The Senior Provider Service Representative is responsible for assisting in the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training and development of external provider education programs. Senior Provider Service Representatives assist in the design and implementation programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Other responsibilities include supporting those who direct and implement strategies relating to the development and management of a provider network, identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims. 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.
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 / GED
1+ years of current CSP Facets experience
1+ years of Managed Care or Medical Insurance experience (e.g., billing practices, terminology)
1+ years of experience in a Claims, Provider Related Customer Service or Provider Support role
Experience utilizing Microsoft Excel (data sorting and filtering) and Microsoft Word (create documentation) 
Preferred Qualifications:

Experience analyzing data to determine root cause of issue
Microsoft Excel (more advanced skills including VLOOKUP)
Ability to work with Physicians, Ancillary and Facility Claims, including understanding of internal claims and payment policies and procedures
Ability to work with Physician, Ancillary and Facility Contracting Methodologies (e.g., in-network vs. out-of-network, contracted rates, medical agreement configurator)
Soft Skills:

Experience managing multiple tasks within established timelines
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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: CSP Facets, Claims, Provider Related Customer Service