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UnitedHealth Group Credentialing Representative - Norristown, PA in Norristown, Pennsylvania

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

This is an opportunity that's all about where you've been. Your experience. Your potential. Your skills. All pretty strong up to now. It's also an opportunity about what's ahead. Because on the team at UnitedHealth Group , your potential and your impact can be career changing. We're building and maintaining extensive provider networks to serve our customers. Our goal is to attract and secure relationships with the best in every specialty and every community. As a member of our provider credentialing team, you'll help us vet and document the competencies of physicians and other providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

Making this kind of impact is no easy task. 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.

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.

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

  • Apply knowledge/skills to a range of moderately complex activities

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

  • Extensive work experience within own function

  • Work is frequently completed without established procedures

  • Works independently

  • May act as a resource for others

  • May coordinate others' activities

Required Qualifications:

  • High School Diploma / GED (or higher)

  • 2+ 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 (have the ability to sort and create formulas in MS Excel and have the ability to create labels in MS Word)

  • Ability to work from Mon - Fri 7:30-4:00 or 8:00-4:30

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.

If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life’s best work.SM

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.

Keywords: Credentialing Representative, Billing Representative, Credentials, UHG, OptumRX

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