Positions in this function are responsible for end to end loading and error resolution, which could include validating data feeds between NDB and CSP Facets and/or direct load or maintenance into CSP Facets. This position requires in - depth knowledge and higher - level security in NDB and CSP Facets. It requires knowledge of how the systems interact and how to address defects in order to avoid/reduce claim payment issues, directory inaccuracies, member assignment, and state reporting. DLAs make informed decisions to deliver quality results. This position includes auditing contract loads between NDB and CSP Facets for adherence to quality measures and reporting standards.
UnitedHealth Group is working to create the Healthcare system of tomorrow and you can help. Already Fortune 6, 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
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Healthcare system that works better for more people in more ways than ever. Now
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- Utilize database systems and tools to enter and / or research provider data (e.g., NDB; CSP Facets; PhyCon; CAQH; Impact; Navigator; Provider Loading and Maintenance Instructions [PLMI]; etc.).
- End to end loading and error resolution, including validating data feeds between NDB and CSP Facets claims platform.
- Interpret, analyze, and / or update C&S State required data elements and provider record set - up within NDB and / or CSP Facets.
- Review system results to determine whether keyed data is correct or updates are necessary.
- Use pertinent data and facts to identify and solve a range of problems within area of expertise (e.g. Missing or Incorrect Data Elements, Incorrect Provider Set - up, NDB to CSP Feed Error Resolution, etc.).
- Investigate, interpret, analyze and process non - standard requests and problems, often in form of special projects and ad - hoc requests.
- Communicate directly with the Network Account Manager, the Contract Analysts and / or external partners to gain clarification tied to provider demographic and contractual data within NDB and/or CSP Facets, if needed.
- Conduct a full system End to end review on provider installation and administration of assigned tasks
- Uses pertinent data and facts to identify and solve a range of problems within area of expertise.
- Investigates and analyzes non - standard requests and problems, with some assistance from others.
- Consistently meet target production, quality, and time utilization metrics.
- Develop and maintain productive work relationships
- Prioritize and organize own work to meet deadlines
- High School Diploma / GED or higher
- 1+ years of experience of data entry experience
- 1+ years of customer service experience
- 1+ years of experience utilizing at least one of the following Provider or Claims databases: NDB and/or CSP Facets
- 1+ years of experience with provider data (demographic and / or contractual) including provider data load and/or maintenance, claims, or member assignment
- 1+ years of experience in a role requiring in - depth research and / or analysis
- Demonstrated understanding of internal processes and procedures for loading, maintaining, and / or resolving system feed related errors
- Intermediate level of proficiency with MS Office - Microsoft Word (create correspondence and work within templates), Microsoft Excel (ability to sort, filter, and create simple spreadsheets), and Microsoft Outlook (email and calendar management)
- Undergraduate degree or equivalent 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.