Credentialing Representative

Credentialing Representative Location Remote in Columbus, OH :

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life's best work. SM

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Process provider applications including mailing, reviewing against established criteria, primary source verifications, and loading into the Salesforce and database tracking systems
• Notify providers of the credentialing review process outcomes, including options for reconsideration
• Apply knowledge/skills to a range of moderately complex activities
• Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
• Provide credentialing support and subject matter expertise to internal operations teams including but not limited to contracting, demographics and loading team
• Plan, prioritize, organize and complete work to meet established objective
• Perform outreach via phone, fax, and e-mail to obtain missing information needed to complete provider credentialing files. This may require professional communication with providers, office managers, state agencies, academic institutions and other resources as applicable to the provide
• Works independently
• Other duties, as assigned

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma/GED (or higher)
• 1+ years of experience in provider credentialing or within provider services
• 1+ years of experience in a healthcare or corporate environment
• 1+ years of data entry experience
• Intermediate level of proficiency with Microsoft Office including Word, Excel, and Outlook

Preferred Qualifications:

• Experience in researching and applying government regulatory information
• Experience working with compliance workflows and processes
• 1+ years of healthcare provider or Home and Community Based Services credentialing experience
• Proficient at utilizing multiple claims screens to compare provider data already in the system with that of the request

• All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii or Washington Residents Only : The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, or Washington residents is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.

#RPO, #Green