Senior Credentialing Representative

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

Job Description - Senior Credentialing Representative (2387745)

Senior Credentialing Representative - 2387745

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 Senior Credential Representative
. Senior Credential Representative will be responsible for enrolling behavioral health providers with appropriate payers for associated entities.

Monday through Friday from 6:00AM - 6:00

PMCST. The schedule will be determined by the supervisor upon hire.

You’ll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges.

• 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
• Solve complex problems on own; proactively identifying new solutions to problems
• 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
• Help develop credentialing policies and procedures and, oversee primary source verification activities
• Investigate non-standard requests and problems
• Leverages subject matter expertise to support and advise team members on functional processes and best practices.
• Takes initiative in evaluating complex requests, recommending solutions, and resolving issues independently.
• Facilitates onboarding and training for new employees and delivers targeted coaching and retraining for team members requiring additional support or development.
• Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements
• Performs other duties as assigned

• 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 direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• High School Diploma/GED
• 3 + years of healthcare customer service and/or…