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Provider Enrollment Representative

Provider Enrollment Representative

UnitedHealth GroupCircle Pines, MN, US
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Credential Representative - National Remote

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

You'll enjoy the flexibility 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 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
  • Ability to submit 10 to 15 applications daily
  • 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
  • Performs other duties as assigned
  • What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include :

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
  • 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)
  • 2+ years of experience in submitting at least 10-15 behavioral health provider payer enrollment applications
  • 2+ years of experience with submitting commercial payer enrollment applications
  • 2+ years of experience in submitting enrollment applications to that include at least 10 different payer enrollments within these states-Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, Nebraska
  • 2+ years of experience in submitting follow ups and issue resolutions from at least 10 different payer enrollments from these states Oklahoma, Hawaii, Arizona, Wisconsin, Minnesota California, Washington, Oregon, Nebraska
  • 2+ years of experience working with compliance workflows and processes, including NCQA policies and practices
  • 2+ years of experience in researching and applying government regulatory information
  • Intermediate level of proficiency with MS Excel and Word
  • Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
  • Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage 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, and maintain good judgment and accountability
  • Ability to multi-task and prioritize tasks to meet all deadlines
  • Ability to work well under pressure in a fast-paced environment
  • Demonstrated ability to work well with health care providers and team members
  • Strong organizational and time management skills
  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
  • Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.74 to $31.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

    Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

    UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

    UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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