Credentialing Representative

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.
Come make an impact on the communities we serve as we help advance health equity on a global scale.
Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.
SM The Credentialing Representative will build and maintain a successful working relationship between OptumServe and network practitioners to ensure a stable practitioner network.
They will be facilitating successful maintenance of practitioners by performing ongoing monitoring processes of all required network practitioners in accordance with industry and contractual standards.
The Credentialing Representative will communicate with outsourced vendors, healthcare facility point of contact / professionals, as well as internal staff to maintain a detailed and compliant practitioner file.
As a part of the Credentialing Team, they ensure the practitioner network meets or exceeds quality, contract, and credentialing expectations to foster continued quality improvement and risk management efforts.
You'll enjoy the flexibility to telecommute* from anywhere within the U.
S.
as you take on some tough challenges.
Primary Responsibilities: Identify and document credentialing, compliance and contract requirements as practitioners enroll in OptumServe’s network to include maintenance of practitioner record Initiate, retrieve, and follow up on all credentialing ongoing monitoring reports and content needed for OptumServe’s practitioner network.
Ensure data integrity is intact to meet requirements for primary source verification Ongoing monitoring of credentialed network for accuracy or any change in status to include regular internal practitioner record audits Analyzes and investigates within scope of the role Provides explanations and interpretations within area of expertise Ability to perform detailed work with a high degree of accuracy Ability to think analytically, multi-task, and time management skills Ability to work independently, as well as with a team Ability to navigate multiple websites and databases Ability to demonstrate an appropriate level of assertiveness in performing work responsibilities under deadlines 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) 1+ year of experience in credentialing and/or healthcare 1+ year of experience using phone and computer as your primary work tools Intermediate proficiency using Microsoft Office Suite including Word (ability to create, edit, save, and send documents), Excel (ability to create, edit, save, and send spreadsheets), and Outlook (ability to send / receive emails) Intermediate proficiency using Adobe Acrobat (ability to create, edit, save, and send documents) Preferred Qualifications: Healthcare terminology experience National Career Readiness Certificate Knowledge of practitioner credentialing and primary source verification of medical/dental licensure Database experience and working with electronic files / documents Soft Skills: Excellent verbal and written communication skills Able to communicate effectively with a diverse group of people/disciplines at all levels of an organization Ability to work in a fast-paced environment, flexible and adaptable to changing situations in order to meet strict deadlines Ability to demonstrate an appropriate level of assertiveness in performing work responsibilities and in making work related decisions Ability to perform detailed work with a high degree of accuracy Strong analytical thinking, multi-tasking, organizational and time management skills Ability to work independently as well as with a team *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii or Washington Residents Only: The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island or Washington residents is $16.
54 to $32.
55 per hour.
Pay is based on several factors including but not limited to education, work experience, certifications, etc.
In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life.
Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes.
We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.
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.
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