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Company

Optum · 20 hours ago

Credentialing Representative - National Remote

Eden Prairie, MN

Full-time

Remote

Mid Level

$16.54/hr - $32.55/hr

3+ years exp

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H1B Sponsor Likely

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Responsibilities

Process monthly roster submissions to all payors for payor enrollment.

Prepare initial applications and re-applications including initial mailing, review and loading into the database tracking system.

Responsible for monthly payer roster submissions

Responsible for monitoring application progress and follow-up with payers as needed until confirmation is received

Conduct audits and provide feedback to reduce errors and improve processes and performance

Work collaboratively with the team to identify, track, and resolve provider application issues and with projects when assigned

Work independently and assume assigned responsibilities timely

Excellent interpersonal skills including verbal and written communications skills

Ability to communicate effectively with our payer representative, peers and leadership via email or within our team meetings

Resolve credentialing issues as they arise and provide updates to senior leadership

Utilizes credentialing database to maintain credentialing data including ongoing credentialing updates, within demographics and enrollment status

Utilizes AdHoc and recurring credentialing reports for enrollment status and roster submissions

Apply knowledge/skills to a range of moderately complex activities

Knowledge of revalidation request issued by all payers

Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others

And all other duties as assigned

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Healthcare provider credentialingCompliance workflowsNCQA policiesGovernment regulatory researchMS ExcelMS WordCAQHGroup mailbox managementPayer enrollment

Required

High School Diploma/GED or higher

3+ years of healthcare provider credentialing experience

1+ years’ experience working with compliance workflows and processes, including NCQA policies and practices

1+ years’ experience in researching and applying government regulatory information

Intermediate level of proficiency with MS Excel and Word

Preferred

Knowledge of CAQH

Experience managing a group mailbox

Payer enrollment experience

All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Company

Optum

Glassdoor

3.6

Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.

Founded in 2011

Eden Prairie, Minnesota, USA

10001+ employees

https://www.optum.com/

H1B Sponsorship

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Trends of Total Sponsorships

2023 (470)

2022 (822)

2021 (646)

2020 (458)