Credentialing Representative Job Appleton area,Wisconsin USA,Healthcare

Improve the lives of others while Caring. Connecting. Growing together.

Job Description
- Credentialing Representative (2326548)

Credentialing Representative - 2326548

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.

Optum has an immediate opening for a
Credential Representative
- National Remote
.
Credential Representative
- National Remote
will be responsible for enrolling behavioral health providers with appropriate payers for associated entities.

Schedule:

Monday
- Friday, 8:00AM - 5:00PMcentral standard time

Primary Responsibilities:

Identify and document credentialing, compliance and contract requirements as they enroll in Optum Serve’s network, including the creation and maintenance of practitioner records within databases
Initiate credentialing processes, retrieve, verify/ follow up on all credentialing applications and supporting documentation needed for Optum Serve’s practitioner network. Ensure credentialing applications are complete, data integrity is intact within databases to meet requirements for primary source verification and industry standards
Perform quality reviews on credentialing files throughout each credentialing cycle
Monitor and facilitate complete and accurate re-credentialing of practitioners on a 3-year cycle
Act as the liaison between the practitioner network and internal departments to troubleshoot issues or answer any questions/concerns
Ongoing monitoring of credentialed network for accuracy or any change in status to include regular internal practitioner record audits
Submit appropriate practitioner records to CVO (Certified Verification Organization) or other credentialing vendor, if applicable. Retrieve and review CVO or other credentialing vendor files as completed, if applicable
Submit background checks as required on credentialed practitioners to contracted vendors. Retrieve and review the completed background check reports as part of the credentialing packet
Performs other duties as assigned

What are the reasons to consider working for United Health Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success.

Some of our offerings include:

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
1+ years of experience in credentialing and/or healthcare
1 + years of computer proficiency with MS Excel and Word
Ability to work a 40-hour week between 8:00 am to 5:00 pm Central Standard time
Ab…