Senior 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. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Based on the role's needs, the anticipated schedule for this role is approximately 8:00am-4:30pm Central Time Zone, regardless of state of residence. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Gathers required information and documents from providers to appropriately enroll them with our contracted payers Submits onboarding validation form to ensure providers are built appropriately in our Epic billing system so claims are accurate Completes payer enrollment applications for newly onboarded providers and/or add locations for existing providers Performs tracking and follow-up on payer enrollment applications to ensure providers are linked appropriately with the payer; and updates MDStaff and Marketware software applications Participates and provides consistent updates to onboarding team and clinic leaders to ensure timelines are met to complete the credentialing process with our payers Communicates effective dates and payer updates to billing and clinic leaders to ensure claims are billed appropriately Manages each provider's Council for Affordable Quality Healthcare (CAQH) and National Provider Identifier (NPI) accounts Establishes close working relationships with providers, clinic leaders, billing leaders, managed care, and payer contacts Pulls reports from MDstaff as needed for various departments and to verify completion of payer enrollments Identifies and reviews credentialing alerts with clinic leaders Maintains and ensures provider licensure, certificate of insurance, and network expirations Submits re-validations and re-credentialing to Medicare and Medicaid, and other contracted networks Assists providers and clinic leaders in a thorough understanding of the credentialing/enrollment processes and policies What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

High School Diploma/GED Intermediate level of proficiency with MS Excel and Word Willingness to work an approximate shift from 8:00am to 4:30pm Central, regardless of USA time zone residing in Preferred Qualifications: 4+ years of healthcare provider payer enrollment credentialing experience 2+ years of experience working with compliance workflows and processes, including Joint Commission policies and practices 2+ years of experience in researching and applying government regulatory information Experience