[Hiring] Senior Credentialing Representative @UnitedHealth Group

Role Description

Senior Credential Representative will be responsible for enrolling behavioral health providers with appropriate payers for associated entities.

Schedule: Monday through Friday from 6:00AM - 6:00PM CST. The schedule will be determined by the supervisor upon hire.

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 and re-applications including initial communications, verifications, review and loading into the databases.
• Conduct quality audits and provide feedback to reduce errors and improve processes and performance.
• Solve complex problems on own; proactively identifying new solutions to problems.
• Apply knowledge/skills to a range of moderately complex activities.
• Demonstrate great depth of knowledge/skills in own function and function as an information resource to others.
• Analytical skills for data analysis from multiple sources.
• Ability to prioritize daily responsibilities.
• Help develop credentialing policies and procedures and oversee primary source verification activities.
• Investigate non-standard requests and problems.
• Leverage subject matter expertise to support and advise team members on functional processes and best practices.
• Take initiative in evaluating complex requests, recommending solutions, and resolving issues independently.
• Facilitate onboarding and training for new employees and deliver targeted coaching and retraining for team members requiring additional support or development.
• Get ready for some significant challenge. This is a performance-driven, fast-paced environment where accuracy is key.
• Perform other duties as assigned.

Qualifications

• High School Diploma/GED
• 3+ years of healthcare customer service and/or administration experience
• 3+ years of healthcare provider credentialing experience
• Advanced level of proficiency with Microsoft Excel and Microsoft 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

Requirements

• Experience working with compliance workflows and processes, including NCQA policies and practices (Preferred)
• Experience researching and applying government regulatory information (Preferred)

Benefits

• 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.)