About UHG

Careers at UnitedHealth Group


We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Network Management



Approximate Salary:

Not Specified

Position Type:

Full Time

Credentialing Representative - US Telecommute

UHG - Dallas, Texas

Posted: 11/12/2018

UnitedHealth Group is working to create the Healthcare system of tomorrow and you can help. We are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high - performance Healthcare system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed. Join with us and start doing your life’s best work.SM
The Credentialing Representative is responsible for activities associated with credentialing or re-credentialing providers, including processing provider applications, initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. The Credentialing Representatives will assist with audits and provide feedback to reduce errors and improve processes and performance.
Primary Responsibilities:
  • Apply knowledge / skills to complex activities
  • Demonstrate a depth and breadth of knowledge / skills in own area and is often able to apply these outside of own function
  • Often act as a technical resource to others in own function
  • Anticipate customer needs and proactively identify solutions
  • Solve complex problems on own; proactively identify new solutions to problems
  • Plan, prioritize, organize and complete work to meet established objectives
  • Act as a facilitator to resolve conflicts on team; seen as key team member on project teams spanning more than own function
  • Act as the primary credentialing contact and provide credentialing support to regional health plans. This includes but is not limited to:
    • Overview and training of provider credentialing processes, tools and databases
    • Issue resolution
    • Market or product specific special requests
    • Audit support
  • Provide credentialing support and subject matter expertise to internal operations teams including but not limited to contracting, demographics and loading teams
  • Perform outreach via phone, fax and e - mail to obtain missing information needed to complete provider credentialing files. This may requires professional communication with providers, office managers, state agencies, academic institutions and other resources as applicable to the provider.
  • Notify all providers and other relevant staff of those providers that fail to meet criteria of the credentialing review process, potential outcomes and options for reconsideration
  • Assist in the creation and implementation of departmental policies and procedures, related to this position's responsibilities, including process flow charts
  • Assist as needed with departmental quality improvement activities including staff training and updates to departmental policies and procedures
  • Other duties, as assigned

Required Qualifications:
  • High School Diploma / GED
  • 1+ year of experience working with Microsoft Word (opening letters and entering information into fields, data entry) and MS Excel (opening documents, searching, sorting and capturing print screen data as well as template data entry) and Adobe Acrobat (edit docs, merge docs, pdf conversion) 

Preferred Qualifications:

  • Experience in Researching and Applying Government Regulatory Information
  • Experience working with Compliance workflows and processes
  • 1+ year of Health Care Provider or Home and Community  Based Services Credentialing experience
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

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, Provider Credentialing, Medicaid, Home & Community

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