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Provider Data Specialist
4 months ago
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.**
The position of Provider Data Specialist will support the day-to-day activities of the Provider Data Integrity team pertaining to research and preparation of paperwork required to update data systems with the health plans.
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities**:
- Consistently exhibits behavior and communication skills that demonstrate Optum’s commitment to superior customer service, including quality, care, and concern with each internal and external customer
- Collaborates with other departments to ensure accuracy and completeness of provider demographic information and coordinate communication of such information to Provider Configuration team which includes, but is not limited to Credentialing, Claims, Payor Contracting, Marketing, MCA, Contract Operations, and regional personnel
- Communicates and interfaces with Optum’s regions and sites regarding questions on provider participation with individual payors
- Distribute Health Plan confirmations that come in after submissions are submitted
- Research and respond to provider demographic validation request
- Upload and distribute all incoming provider data request
- Salesforce and/or SmartSheet
- Gathers and consolidates provider data from a variety of internal and external sources
- Organizes all provider contract data required to be submitted to payors
- Assists in various projects regarding provider participation with various product lines and/or payors
- Follow-up and assist, where necessary, in monitoring the integrity of data in the database systems
- Attends department meetings as required
- Assists in the coordination of the roster validation and audit processes as needed
- Uses, protects, and discloses Optum patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
**ADDITIONAL FUNCTIONS**:
- Lead training initiatives and work with management team to document and implement procedural changes
- Provide cross-coverage for other specialist when required
- Additional duties as assigned
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)
- 2+ years of customer service experience
- 2+ years of data entry experience
- 2+ years of HIPPA experience
- Intermediate level of proficiency with Microsoft Office products including Excel, Word, and Outlook
**Preferred Qualifications**:
- Previous healthcare experience
- Salesforce experience
- Administrative experience
- All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
***
- 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._
RPO, #Green
