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The Credentialing Representative is responsible for activities associated with credentialing or re-credentialing physicians and providers, including processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Credentialing Representatives will assist with 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.
- Sometimes act as a technical resource to others in own function.
- Proactively identify solutions to non-standard requests.
- Work with team to solve complex problems.
- Plan, prioritize, organize and complete work to meet established objectives.
- High School Diploma/GED
- Healthcare Customer Service experience
- Experience working with compliance workflows and processes including NCQA policies and practices
- Provider Credentialing experience
- Experience in researching and applying government regulatory information
- Experience with NDB or similar platform
- Medical credentialing experience
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.