Healthcare Credentialing Specialist
5 days ago
About the Role:
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. As a Healthcare Credentialing Specialist, you will play a critical role in connecting people with the care, pharmacy benefits, data and resources they need to feel their best.
Key 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
Requirements:
- 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
Benefits:
UnitedHealth Group offers 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.
Equal Employment Opportunity:
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.
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