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Credentialing Coordinator job at UnitedHealth Group, Orlando

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Careers with LHI. Our focus is simple. We’re innovators in cost-effective health care management. And when you join our team, you’ll be a partner in impacting the lives of our customers, and employees. We’ve joined OptumHealth, part of the UnitedHealth Group family of companies, and our mission is to help the health system work better for everyone. We’re located on the banks of the beautiful Mississippi River in La Crosse, Wis., with a satellite office in Chicago and remote employees throughout the United States. We’re supported by a national network of more than 25,000 medical and dental providers. Simply put, together we work toward a healthier tomorrow for everyone. Our team members are selected for their dedication and mission-driven focus. For you, that means one incredible team and a singular opportunity to do your life’s best work.(sm)

The Credentialing Coordinator will build and maintain a successful working relationship between LHI and network practitioner to ensure a stable practitioner network. They will be facilitating successful activation and maintenance of practitioner by performing initial credentialing, ongoing monitoring, and re-credentialing process of all required network practitioners in accordance with industry standards. The Credentialing Coordinator will communicate daily with outsourced vendors, healthcare facility points of contact / professionals, as well as internal staff to maintain a detailed and compliant practitioner file credentialing system for various company contracts. As a part of the Credentialing Team, they ensure the practitioner network meets or exceeds quality, contract, and credentialing expectations to foster continued quality improvement and risk management efforts. 

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Identify and document credentialing, compliance, and contract requirements as the enroll in LHI's network to include creation and maintenance of practitioner record within database

  • Initiate, retrieve, verify, and follow up on all credentialing applications and content needed for LHI's practitioner network. Ensure applications are complete, data integrity is intact within database to meet requirements for primary source verification

  • Monitor accurate re-credentialing of practitioners on a three-year cycle

  • Act as the liaison between the practitioner network and internal departments to troubleshoot issues or answer any questions/concerns

  • Ongoing monitoring of credentialed network for accuracy or any change in status to include regular internal practitioner record audits

  • Submit appropriate practitioner records to CVO (Certified Verification Organization). Retrieve and review CVO file as completed

  • Submission of background checks as required on credentialed practitioners to contracted vendor. Retrieval and review of the reports as part of the credentialing packet

What are the reasons to consider working for UnitedHealth Group?  Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays

  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account

  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage

  • 401(k) Savings Plan, Employee Stock Purchase Plan

  • Education Reimbursement

  • Employee Discounts

  • Employee Assistance Program

  • Employee Referral Bonus Program

  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

  • More information can be downloaded at: http://uhg.hr/uhgbenefits

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications: 

  • Associate degree (or higher) in Health Information Technology, Business, or related field and 1+ year experience in credentialing / healthcare – OR – a combination of college education, credentialing experience, healthcare experience, and / or military experience totaling at least 3 years

  • Intermediate to Expert level experience using Microsoft Office Suite including Word (ability to create, edit, save, and send documents), Excel (ability to create, edit, save, and send spreadsheets), and Outlook (ability to send / receive emails)

  • 6+ months of experience using phone and computer as your primary work tools

  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. 

Preferred Qualifications:  

  • Healthcare terminology experience

  • Certified Provider Credentialing Specialist (CPCS) through the National Associate Medical Staff Services

  • National Career Readiness Certificate

  • Familiarity with NCQA credentialing standards

  • Knowledge of practitioner credentialing and primary source verification of medical/dental licensure

  • Database experience and working with electronic files / documents 

To protect the health and safety of our workforce, patients, and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state, and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So, when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $16.00 to $26.88. The salary range for Connecticut / Nevada residents is $16.83 to $29.66. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives 

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.

Job Keywords: credentialing, healthcare, excel, telecommute, compliance, contract, requirements, LHI, practitioner, remote, work from home, work at home, WFH, WAH, #RPO, #Green, hiring immediately

Job country: United States

City: Orlando

Category: Business Operations Specialists, All Other

Location: Orlando, FL, United States

Job posted 2022-06-04

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