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Job Information

UnitedHealth Group Senior Credentialing Rep - Remote in the Boulder, CO area in Boulder, Colorado

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

Responsible for the operational oversight of Insurance Payer credentialing. Responsible for credentialing providers and clinic locations with Federal/State organizations (Medicare/Medicaid) as well as contracted managed care payers. Responsible for communicating provider status changes to applicable clinic\billing staff and Federal/State/Managed care payers. Serves as the primary liaison between billing staff and payers when reimbursement issues arise due to credentialing activities. Serves as the primary liaison between billing and Medical Staff personnel. Serves as central point of contact between Medical Staff and employed Ambulatory Services providers to help facilitate timely completion of Medical Staff reappointments. Serves as primary liaison between providers and billing office for all payer credentialing activities. Serves as an educational resource for credentialing activities to provider\clinic\billing staff when necessary.

Primary Responsibilities:

  • Responsible for the operational oversight of Insurance Payer credentialing. Responsible for all Payer required credentialing activities for providers and clinic locations with Federal/State organizations (Medicare/Medicaid) as well as contracted managed care payers. Responsible for maintaining database/logs for payer credentialing.

  • Serves as central point of contact between Medical Staff and employed Ambulatory Services providers to help facilitate timely completion of Medical Staff reappointments. Serves as the primary liaison between Billing and Medical Staff personnel.

  • Serves as primary liaison between providers and Billing for all payer credentialing activities.

  • Serves as the primary liaison between Billing staff and Payers when reimbursement issues arise due to credentialing activities.

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

  • 4+ years of health care provider credentialing experience

  • 2+ years’ experience working with compliance workflows and processes, including NCQA policies and practices

  • 2+ years’ experience in researching and applying government regulatory information

  • Intermediate level of proficiency with MS Excel and Word

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

Colorado Residents Only: The hourly range for Colorado residents is $17.12 to $30.34. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: Credentialing Coordinator, healthcare, LHI, UHG, Optum, remote, telecommute, work from home, work at home, WFH, WAH, hiring immediately, #RPO

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