UnitedHealth Group

Senior Provider Data Specialist - Remote Nationwide

Posted on: 6 Feb 2021

Johnstown, PA

Job Description

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

Senior Provider Data Specialists on the Specialty Ops Team are responsible for knowing the specific job functions which they are required to perform such as Tax, CSP (Customer Sponsored Providers), PCP Reassignment, Member Notification/PTS, EMCCF, HIPAA 835, NDB Hold Code/200, and New York Surcharge. Senior Provider Data Specialists make informed decisions to deliver quality results and are responsible for properly maintaining the provider data housed in our core systems to allow for proper claim payment and member directory information.

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

Primary Responsibilities:

* Utilize database systems and tools to enter and/or research provider data
* Receive data from multiple inbound sources (e.g. Excel spreadsheets, e-mail, SharePoint, etc.)
* Research multiple databases to pull in the correct or needed information
* Learn and effectively use multiple platforms and systems
* Interpret instructions that accompany the inbound data
* Contact internal or external data submitter to verify/clarify information and/or data to be entered, when required
* Demonstrate an understanding of and apply business strategies, rules, and procedures, as appropriate (e.g., determine whether to reject or accept data prior to entry)
* Ensure keyed data is correct using most current Standard Operating Procedure (SOP) updates
* Maintain current knowledge of business strategies, rules, and procedures (e.g. attend training, team meetings, read email communications)
* Participate in applicable ad hoc projects as assigned
* Consistently meet compliance targets, quality and time utilization metrics
* Accurately report time and productivity activities (e.g. completed tasks, personal time, etc.) throughout work shift
* Demonstrate good communication skills in dealing with business partners
* Be a team player; understand individual efforts will combine to achieve overall success.
* Use good judgment to challenge our current processes/procedures and submit recommendations to develop more efficient solutions for the team and higher quality for providers

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:

* High School Diploma/GED required
* 1 year or more of customer service experience
* 1 year or more of experience with the Microsoft Suite (particularly, Excel, Word and Outlook)
* 1 year or more of data entry experience

Preferred Qualifications:

* Experience in a medical office setting
* Experience with dual monitor environment
* Excellent communication, time management, problem solving, and organizational skills
* NDB experience
* Understanding of UnitedHealth Group's mission and strategy
* Proven ability to handle multiple tasks and meet deadlines within standards
* Ability to prioritize, approaching each new activity with a sense of urgency, and follow through to successful completion
* Demonstrated behavior consistent with UnitedHealth Group culture and values

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID-19 and support impacted communities: click here.

Colorado Residents Only: The hourly range for Colorado residents is $17.12 to $30.34. 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.

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UnitedHealth Group

Hopkins, MN

UnitedHealth Group Incorporated operates as a diversified health care company in the United States. It operates through four segments: UnitedHealthcare, OptumHealth, OptumInsight, and OptumRx. The UnitedHealthcare segment offers consumer-oriented health benefit plans and services for national employers, public sector employers, mid-sized employers, small businesses, and individuals; health and well-being services to individuals age 50 and older, addressing their needs for preventive and acute health care services, as well as services dealing with chronic disease and other specialized issues for older individuals; and Medicaid plans, Children’s Health Insurance Program, and health care programs; and health and dental benefits.

The OptumHealth segment provides access to networks of care provider specialists, health management services, care delivery, consumer engagement, and financial services. This segment serves individuals through programs offered by employers, payers, government entities, and directly with the care delivery systems.

The OptumInsight segment offers software and information products, advisory consulting arrangements, and services outsourcing contracts to hospital systems, physicians, health plans, governments, life sciences companies, and other organizations. The OptumRx segment provides pharmacy care services and programs, including retail network contracting, home delivery, specialty and compounding pharmacy, and purchasing and clinical, as well as develops programs in areas, such as step therapy, formulary management, drug adherence, and disease/drug therapy management. UnitedHealth Group Incorporated was founded in 1974 and is based in Minnetonka, Minnesota.