Credentialing Representative (Payer Enrollment) – National Remote

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Overview of business:

Shared services organization supporting businesses that deliver behavioral health care services

Team is comprised of 3 regional teams supporting over 70 behavioral health clinics across the US

Primary goal of the team is to complete credentialing of providers and enroll with commercial and government payers

You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

Accurate and timely submission of payer enrollments

Timely, concise documentation of provider enrollment work in database

Timely, frequent payer follow-up to confirm enrollment and effective dates

Monitoring of work assignments to ensure all work is completed

Maintaining accurate records of all work

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)

5 years of experience in submitting at least 10-15 behavioral health provider payer enrollment applications

5 years of experience with submitting commercial payer enrollment applications

5 years of experience with payer enrollment follow-up and issue resolution

Intermediate level of proficiency with Microsoft Office products including Excel, Word and Outlook

Preferred Qualifications:

Medicare/Medicaid experience

Knowledge of payers such as Aetna, Optum, Beacon, BCBS, Mutiplan, Tricare, Caresource, MD Wise, MHS Health, Wellcare, Buckeye, Molina, OSU Healthplan, Ohio Healthy, Med Mutual, Paramount, Behavioral Health Systems, Healthy Alliance, McLaren Health Plan, Priority Health, PHP, IU Health, HFN and PCN

Knowledge of provider enrollment applications for the following states: Arkansas, Michigan, Ohio, Indiana, Tennessee, Illinois, Kentucky, Louisiana, Wisconsin, Hawaii, Arizona, Oregon, Utah, California, Washington, Nebraska, Minnesota, Oklahoma

Soft Skills:

Effective time management and ability to multi-task

Demonstrated ability to successfully work in a production environment

Keen attention to detail

Self-starter

Ability to work independently and as 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, Washington or Washington, D.C. Residents Only: The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii, Washington or Washington, D.C. residents is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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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