Provider Service Representative

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.SM

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

Primary Responsibilities:

• Apply knowledge/skills to activities that often vary from day to day.
• Demonstrate a moderate level of knowledge and skills in own function.
• Require little assistance with standard and non-standard requests.
• Solve routine problems on own.
• Work with supervisor to solve more complex problems.
• Prioritize and organize own work to meet agreed upon deadlines.
• Work with others as part of a team. 
• Some work is completed without established procedures.
• Basic tasks are completed without review by others.
• Supervision/guidance is required for higher level tasks.
• Analyze data; summarize & present findings to co-workers and leaders
• Document and maintaining a change management process

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 (or higher) OR 4 years of experience working with a managed care organization or health insurer; or as a consultant in a network/contract management role, such as contracting, provider services, etc.
• 2 years of experience working with a managed care organization or health insurer; or as a consultant in a network/contract management role, such as contracting, provider services, etc.
• 2 years of experience in claims research, analysis and reporting
• 2 years of experience in data analysis
• 2 years of experience with claims systems
• 6 months of experience with provider relations or provider relations support experience
• Expert level of proficiency with MS Excel (include visual basis, advanced formulas, and data presentation features)
• Advanced level of proficiency with MS Access & SQL database; ability to build & maintain a database; write queries to analyze and extract necessary data elements
• Intermediate level of proficiency with extracting and combing data received in various formats (csv; txt, doc, pdf, xls, delimited)

Preferred Qualifications:

• Bachelor's Degree (or higher)
• Experience working in a .NET environment
• Experience building & maintaining SharePoint sites
• Experience conducting audits
• Experience working with Altair Monarch application to extra data elements from various file formats
• Experience working with UMR's Provider File System (aka: PFS); UMR's Claim Processing System (CPS); UMR's Claim Update System (CUS)
• Experience working with NDB, EPIM, NPPES, FACETS;

Careers with UnitedHealthcare. Work with a Fortune 5 organization that's serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

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

California, Colorado, Connecticut, Nevada, New York City, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, Washington or New York City residents is $18.80 to $36.78. 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.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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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