Provider Relations Coordinator

1 week ago

Signal Hill, United States Optum Full time

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.**

Responsible for supporting the operations of the affiliate provider network and serving as a resource for the provider network, Operations team, and provider relations teammates to drive superior clinical quality and outcomes for Optum patients.

**Location**: Signal Hill, CA 90755

**Primary Responsibilities**:

- Serves as administrative support for the Provider Relations team
- Resolves provider issues by interfacing with cross functional Optum teams
- Conducts claims research and collaborates with the claims department for issue resolution
- Helps the Operations team plan, prepare, and execute specialist provider events and meetings
- Coordinates with internal departments on status of clinician adds, terms and panel changes
- Serves as a point of contact for internal departments for issues related to the network
- Communicates relevant information from internal departments to the provider network
- Makes outreach and follow-up phone calls to physician offices related to specific initiatives
- Submits provider adds/changes, practice location adds/changes, and referral status changes ensuring data integrity in internal systems (IDX, Curo, etc.) and health plan websites
- Responsible for incoming calls from provider network
- Responds to and resolves questions or concerns from clinicians or staff in a timely and service-oriented manner
- Manages provider network rosters
- Other 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 and/or consultative sales experience
- 2+ years of experience with healthcare claims
- 2+ years of experience in the healthcare industry
- Intermediate level of proficiency with MS Word, Excel, PowerPoint
- Ability to work in office Monday through Friday from 8am-5pm PST at Signal Hill, CA 90755

**Preferred Qualifications**:

- Prior experience in a clinic, medical group, or IPA setting working with physician networks
- An understanding or familiarity with managed care or population health management principles and reimbursement mechanics
- Knowledge of CPT II and ICD-10 coding systems and experience with claims research and resolution

**Soft Skills**:

- Strong customer service and interpersonal skills
- Excellent verbal and written communication skills
- Ability to interface with all levels of management
- 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 #Red

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