Position Description: Through our family of businesses and a lot of inspired individuals, we're building a high-performance Healthcare system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed. Join with us and start doing your life's best work.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.Positions in this function are responsible for all activities associated with credentialing or re-credentialing physicians and providers. Includes processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Conducts audits and provides feedback to reduce errors and improve processes and performance. Responsible for the development of credentialing policies and procedures. May oversee primary source verification activities.Primary Responsibilities:Apply knowledge / skills to a range of moderately complex activitiesDemonstrate great depth of knowledge / skills in own functionSometimes act as a technical resource to others in own functionProactively identify solutions to non-standard requestsSolve moderately complex problems on ownWork with team to solve complex problemsPlan, prioritize, organize and complete work to meet established objectivesMay coordinate work of other team members
Required Qualifications: High School Diploma / GED or higher Customer Service experiencePreferred Qualifications:Experience working with compliance workflows and processes including NCQA policies and practicesMedical / Provider Credentialing experienceExperience in researching and applying government regulatory informationExperience with NDB or similar platformCareers with United HealthCare. Let's talk about opportunity. Start with an 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? United HealthCare 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.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, Credentialing Representative, Shavano Park
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.