Taking a giant leap step forward comes with great challenge. You'll ensure provider service quality by making outbound calls to obtain data and verify information with providers as well as perform analysis and develop reports that help clarify operational issues and opportunities.
- Assist in end - to - end provider claims and help enhance call quality
- Assist in the design and implementation of programs that build / nurture positive relationships between the health plan, providers and practice managers
- Support development and management of provider networks
- Help implement training and development of external providers through education programs
- Identify gaps in network composition and services to assist network contracting and development teams
- High School Diploma / GED or higher
- 2+ years of managed care or medical insurance experience
- 1+ years experience in a claims, customer service or provider support role
- Proficiency with MS programs including Excel and Word with the ability to edit, create, send and save spreadsheets and documents.
Data Entry Skills
- Resolve issues by clarifying the customer's complaint; determining the root cause of the issue and the best solution to resolve the issue, expediting correction or adjustment; following up to ensure resolution. Take lessons learned and share them with team
- Knowledge of medical terminology is a critical for
success, as well as a broad understanding of health insurance
administration processes. Familiarity with CMS guidelines, ICD-10,
CPT, HCPCS and revenue codes.
- Proven oral communication skills including telephone etiquette
Must have excellent verbal and written communication
Exercise Good judgment using data and facts
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is 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: provider, service, representative