Position Description: Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)The Senior Credentialing Representative is responsible for activities associated with credentialing or re-credentialing physicians and providers, including processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Senior Representatives will assist with audits and provide feedback to reduce errors and improve processes and performance. Primary Responsibilities: Positions in this function are responsible for all activities associated with credentialing or re - credentialing physicians and providers. Includes processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Conducts audits and provides feedback to reduce errors and improve processes and performance. Responsible for the development of credentialing policies and procedures. May oversee primary source verification activities.Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.
Required Qualifications: High school diploma / GED or higher 5+ years of healthcare 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 regulatoryInformation.Intermediate level of research and analytical skillsIntermediate level of proficiency with MS Excel and Word. Preferred Qualifications:Sales force backgroundSoft Skills: Strong interpersonal and oral communication skills including telephone etiquette.Good organization and planning skills 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.SMDiversity 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: credentialing representative, researching, workflows, regulatory, United Health Group, united Health care.
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.