Credentialing Representative - National Remote
St. Cloud, Saint Cloud, Stearns County, Minnesota, 56301, USA
Listed on 2026-07-08
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Healthcare
Healthcare Administration, Medical Billing and Coding
Credentialing Representative
- National Remote
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- National Remote role at Optum
- National Remote
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Join to apply for the Credentialing Representative
- National Remote role at Optum
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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 inclusion, talented peers, comprehensive benefits and career development opportunities.
Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Credentialing Representative is responsible for all activities associated with credentialing / re - credentialing providers. Includes processing provider applications, reviewing and loading into the databases ensuring high quality standards. This role is responsible for all activities associated with credentialing or re
-credentialing physicians and other Behavioral providers. Includes processing provider applications including initial communications, verifications, review, and loading into the databases. Conducts audits and provides feedback to reduce errors and improve processes and performance. Responsible for the understanding and adherence of credentialing policies and procedures.
This is a performance driven, fast paced environment where accuracy is key. You will be responsible for ensuring each application meets all NCQA, CMS, State and Federal credentialing requirements.
Schedule:
Monday-Friday, 8-hour shifts between the hours of 6am-6pm CST.
You’ll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities
- Process provider applications and re - applications including initial communications, verifications, review and loading into the databases
- Conduct quality audits and provide feedback to reduce errors and improve processes and performance
- Apply knowledge / skills to a range of moderately complex activities
- Demonstrate great depth of knowledge / skills in own function and function as an information resource to others
- Analytical skills for data analysis from multiple sources
- Ability to prioritize daily responsibilities
- 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.)
- More information can be downloaded at: (Use the "Apply for this Job" box below)./uhgbenefits
Required Qualifications
- High School Diploma/GED (or higher)
- 1+ years of healthcare customer service and/or administration experience
- Intermediate level of proficiency with Microsoft Excel and Microsoft Word
Preferred Qualifications
- Healthcare provider credentialing experience
- Experience working with compliance workflows and processes, including NCQA policies and practices
- Experience researching and applying government regulatory information
- All Telecommuters will be required to adhere to United Health Group’s…
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