Senior Provider Enrollment Representative

Optum; Eugene (OR); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is looking for a Credential Representative to work remotely. This role involves processing applications for health providers and ensuring compliance with various regulations. Candidates should have a High School Diploma and a minimum of 2 years in similar roles, with strong skills in MS Excel and Word. Competitive hourly pay ranges from $20.00 to $35.72 based on experience.

Benefits

Comprehensive benefits package

Incentive and recognition programs

401k contribution

Qualifications

• 2+ years of experience submitting 10-15 behavioral health provider payer enrollment applications.
• 2+ years of experience with compliance workflows and NCQA policies.
• Access to a designated quiet workspace for Protected Health Information.

Responsibilities

• Process provider applications and re-applications.
• Conduct audits to reduce errors.
• Solve complex problems and identify new solutions.

Skills

Intermediate proficiency with MS Excel

Intermediate proficiency with MS Word

Ability to work independently

Excellent organizational skills

Excellent verbal communication skills

Ability to multi-task

Education

High School Diploma/GED

Job description

Overview

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Credential Representative - National Remote has an immediate opening. The Credential Representative - National Remote will be responsible for enrolling behavioral health providers with appropriate payers for associated entities.

Schedule

Mon - Fri, 8:00AM - 5:00PM, any time zone that you reside within. You will be able to telecommute from anywhere within the U.S. as you take on some tough challenges.

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 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 the team
• Perform as a key team member on project teams spanning more than own function
• Submit 10 to 15 applications daily
• Work in a performance-driven, fast-paced environment where accuracy is key and ensure compliance with NCQA, CMS and state credentialing requirements
• Performs other duties as assigned

Benefits and Compensation

Pay is based on several factors including but not limited to local labor markets, education, work experience, and certifications. In addition to salary, benefits may include a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits subject to eligibility requirements).

Hourly pay for this role ranges from $20.00 to $35.72 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Some information can be downloaded at: http://uhg.hr/uhgbenefits

Required Qualifications

• High School Diploma/GED (or higher)
• 2+ years of experience submitting 10-15 behavioral health provider payer enrollment applications
• 2+ years of experience submitting commercial payer enrollment applications
• 2+ years of experience submitting enrollment applications including at least 10 different payer enrollments in states: Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota, California, Washington, Oregon, Nebraska
• 2+ years of experience following up and resolving issues from at least 10 different payer enrollments in those states
• 2+ years of experience with compliance workflows and NCQA policies and practices
• 2+ years of experience researching and applying government regulatory information
• Intermediate proficiency with MS Excel and Word
• Access to a designated quiet workspace at home with the ability to secure Protected Health Information (PHI)
• Live in a location with access to UnitedHealth Group approved high-speed internet or an existing high-speed internet service
• Ability to work from 8:00 am to 5:00 pm CST

Preferred Qualifications

• Knowledge of payers and provider enrollment applications for the following states: Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota, California, Washington, Oregon, and Nebraska

Soft Skills

• Ability to work independently and as a team, with good judgment and accountability
• Ability to multi-task and prioritize tasks to meet deadlines
• Ability to work well under pressure in a fast-paced environment
• Strong ability to work well with health care providers and team members
• Excellent organizational and time management skills
• Excellent verbal and written communication skills and the ability to convey information clearly and interpret information from others
• All Telecommuters must adhere to UnitedHealth Group's Telecommuter Policy

Application deadline: This posting will be available for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may be removed early due to volume of applicants.

UnitedHealth Group is an Equal Employment Opportunity employer. We are committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities. We are a drug-free workplace; candidates may be required to pass a drug test before beginning employment.