You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
The Provider Installation Representative is responsible for various activities related to the Provider Network database which may include: database maintenance, reporting and extracting data for various reports and analyses, and initiating database improvement. The Provider Installation Representative will develop and maintain standards for database integrity and quality assurance, coordinate corrective activities to clean database and retain users, and manage communication processes with other departments regarding database improvements. Other responsibilities include: conducting audits and providing feedback to reduce errors and improve processes and performance, maintaining current provider data to ensure the quality of the network, and may be responsible for representing the provider network area on company IT projects, reporting and tracking provider calls and complaints, or for the support, coordination, and production of the paper directory cycles.
- Maintenance of all provider records within the health plan system(s). Includes: setup of demographic and specialty information, panel information (if applicable), line of business and fee schedule as instructed
- Assists in ensuring that Provider Directories and regulatory requirements are accurate and that errors are root caused and discussed at the global level to ensure appropriate corrections and improvements are made
- Data integrity and quality assurance
- Requests for new or updates to provider records must completed within business mandated service level agreements
- Other assignments and projects as requested
- Solve routine problems on own
- Work with supervisor to solve more complex problems
- High School Diploma / GED (or higher)
- 1+ year of Customer Service experience
- 1+ years of data entry experience
- Proficiency with Microsoft Excel (filter, sort, create and edit spreadsheets)
- Ability to work 8 hour shifts during the core business hours: Monday - Friday 6:30 am - 5:00 pm
- 1+ years of previous experience in a healthcare setting particularly with managed care systems
- Knowledge of Medicaid / Medicare / Commercial rules and regulations
- Previous experience working in a production and quality environment
- Ability to utilize complex database systems and claims platforms simultaneously including, but not limited to OHBS and CSP Facets, COSMOS, and NDB
- Strong research, follow - up, documentation, and issue resolution skills
- Strong root cause analysis skills including the ability to take complex matters and format simplified key concepts to provide clear guidance to internal customers
- Multi - tasking and applying attention to detail
- Ability to work independently and as a team player
- Excellent written and verbal communication skills
- Solid analytical and problem - solving skills using reasoning and available resources to resolve issues
- Independently prioritize and organize own work to complete daily tasks within required business mandated time frames
- Ability to think independently and is not afraid to ask questions with the goal of continuous improvement in mind
- Ability to effectively adapt and adjust to changing business needs
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: UnitedHealth Group, Eden Prairie, Data Entry, Claims, Customer Service, audits, reports, CSP Facets, COSMOS, NDB