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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

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Provider Service Rep - Plano, TX

UHG - Plano, Texas

Posted: 11/12/2018

It's that time, isn't it? You're ready for the next step forward and an opportunity to build on your skills. And it just so happens that there's never been a better time to become a part of the team at UnitedHealth Group. We're driving even higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your knowledge of insurance claims and customer service to help create strong relationships with the providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

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.

Primary Responsibilities
  • 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

Required Qualifications

  • 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.

Preferred Qualifications:

  • 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.
Soft Skills
  • Proven oral communication skills including telephone etiquette
  • Analytical skills                                                   
  • Problem Solving
  • Must have excellent verbal and written communication
  • Customer Focused
  • Exercise Good judgment using data and facts
  •  Integrity
  • Team player

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

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