Credentialing Specialist

Join Optum, a global organization that leverages technology to enhance healthcare delivery, helping millions lead healthier lives. Your role as a Credentialing Specialist will be pivotal in directly improving health outcomes by facilitating access to necessary care, pharmacy benefits, data, and resources. Here, you'll encounter a culture that values diversity and inclusion, along with talented colleagues, comprehensive benefits, and abundant career development opportunities. Come make a significant impact on the communities we serve and help us promote health equity worldwide. Let's start Caring. Connecting. Growing together.

Key Responsibilities:

• Facilitate the processing of provider applications and re-applications including initial mailing, review, and data entry into our tracking system.
• Conduct audits and provide constructive feedback to minimize errors and enhance processes and performance.
• Independently resolve both standard and complex requests.
• Consult with supervisors on intricate issues and challenges.
• Collaborate effectively with team members to achieve common goals.

We reward and recognize outstanding performance in an environment that challenges you and provides clear direction on succeeding in your role, including opportunities for advancement in various career paths.

Required Qualifications:

• High School Diploma or GED (or higher).
• A minimum of 1 year of experience in managed care or medical insurance.
• At least 1 year of experience with provider credentialing, provider relations, medical billing, or quality management.
• Basic proficiency in MS Excel and Word.

Preferred Qualifications:

• Familiarity with CAQH tools.
• Experience with managing a group mailbox.
• Background in payer enrollment.
• Knowledge of NCQA guidelines.

Compensation is based on various factors including local labor markets, educational background, work experience, certifications, and more. We offer a comprehensive benefits package that includes incentive programs, equity purchasing options, and 401k contributions (subject to eligibility requirements). The hourly pay for this position ranges from $17.74 to $31.63 for full-time employment, and we adhere to all applicable minimum wage laws.

At UnitedHealth Group, we are committed to helping individuals live healthier lives while improving the overall health system for everyone. We believe in equitable care for all, regardless of race, gender, sexuality, age, location, or income. With our focus on dismantling barriers to health access faced by marginalized groups, we prioritize initiatives that improve health outcomes and address disparities.

UnitedHealth Group is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to characteristics protected by law, including race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or veteran status.

This is a drug-free workplace, and candidates are required to pass a drug test prior to starting employment.