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[Remote] Credentialing Representative

100% Remote Full-time Open now

Note: The job is a remote job and is open to candidates in USA. Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The Credentialing Representative will process provider applications, conduct audits, and collaborate with team members to improve health outcomes.

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
  • Work independently to resolve standard and non-standard requests
  • Consult with your supervisor on complex issues and problems
  • Collaborate with others on your team

Skills

  • High School Diploma/GED (or higher)
  • 1+ years of experience in credentialing, provider relations, and quality management in healthcare
  • Basic level of proficiency with MS Excel and Word
  • Knowledge of CAQH
  • Experience managing a group mailbox
  • Knowledge of NCQA guidelines
  • Experience with software training (MDStaff)
  • Knowledge of roster management
  • All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

Benefits

  • A comprehensive benefits package
  • Incentive and recognition programs
  • Equity stock purchase
  • 401k contribution

Company Overview

  • Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group. It was founded in 2011, and is headquartered in Eden Prairie, Minnesota, USA, with a workforce of 10001+ employees. Its website is https://www.optum.com/.
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