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Pay Provider Enrollment Specialist

2 months ago


Delano, Minnesota, United States Optum Full time
Job Summary

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.

Key Responsibilities
  • Enrollment and Maintenance: Perform the appropriate processes to enroll and maintain enrollment for Optum Pay providers, including validating provider financial and business information.
  • Enrollment Processing: Review, investigate, and process enrollment using the Optum Pay applications, conducting data entry and re-work as necessary.
  • Fraud Detection: Analyze and identify fraud enrollment trends, providing reports as necessary.
  • Provider Support: Provide expertise or general support by reviewing, researching, investigating, processing, and adjusting Optum Pay enrollments.
  • Account Maintenance: Assist providers with account maintenance to ensure payments are processed accurately.
  • Communication: Make outbound provider calls as needed.
  • Productivity and Quality: Consistently meet established productivity, schedule adherence, and quality standards.
  • Technical Skills: Proficiency with Windows PC applications, including the ability to learn new and complex computer system applications.
  • Security: Safeguard transactions and escalate when applicable.
  • Adaptability: Adapt to changing business objectives.
  • Verification: Verify true providers and the activity on their account.
  • Fraud Schemes: Thoroughly review enrollment items for fraudulent activity and apply expanded knowledge base of fraud schemes to assist in handling of specialized fraud functions such as identity theft and cross-channel fraud.
Requirements
  • Education: High School Diploma / GED.
  • Age: Must be 18 years of age or older.
  • Physical Demands: Ability to sit/stand for extended periods of time.
  • Technical Skills: Proficiency with Windows PC applications, including the ability to learn new and complex computer system applications.
  • Multi-Tasking: Ability to manage multiple systems and applications, as well as multi-task and understand multiple products and multiple levels of benefits within each product.
  • Self-Starter: Self-starter with ability to work independently.
  • Schedule: Ability to work any of our 8-hour shift schedules during our normal business hours of 8am - 4:30pm CST, with occasional overtime as needed.