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Senior Credentialing Representative - Indianapolis, IN or Columbia, MD

Company: UnitedHealth Group
Location: Indianapolis
Posted on: April 10, 2021

Job Description:

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 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)The Senior Credentialing Representative assists in the programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Other responsibilities include working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, training & development of external provider education programs, 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. Primary Responsibilities:

  • Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system
  • Conduct audits and provide feedback to reduce errors and improve processes and performance
  • Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
  • Solve complex problems on own; proactively identify new solutions to problems
  • Act as a facilitator to resolve conflicts on team
  • Perform as key team member on project teams spanning more than own function
  • Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements. 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
    • Intermediate level of proficiency with MS Excel and Word
    • You will be asked to perform this role in an office setting or other company location
    • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas, In addition, employees must comply with any state and local masking orders. Preferred Qualifications:
      • 4+ years of health care provider credentialing experience
      • 2+ years experience working with compliance workflows and processes, including NCQA policies and practices
      • 2+ years experience in researching and applying government regulatory information Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work. SM UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities: click here .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: #RPO - provided by Dice

Keywords: UnitedHealth Group, Indianapolis , Senior Credentialing Representative - Indianapolis, IN or Columbia, MD, Other , Indianapolis, Indiana

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