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Associate Provider Services Representative - Remote

Company: HiringLogistics.com
Location: Schaumburg
Posted on: May 31, 2021

Job Description:

Here you are in the earlier stages of what could be a deeply rewarding career. You have the potential, the energy and the aspiration to take on meaningful challenges and make a difference. Now, let's talk about what you can do with our leading, global health care organization. **UnitedHealth Group** is 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 7 leader.

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

**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

Ready to step to the challenge? We'll call on you to help develop policies and procedures and explore novel solutions for issues and challenges. You'll ensure that contracted rates and reimbursement policies are applied accurately while supporting and reviewing claim disputes, verifying pricing and determining errors/gaps.

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 or GED

+ 1+ years of experience with managed care or medical insurance

+ 1+ years of experience in a claims, customer service or provider support role

+ 1+ years of experience in a role that required strong communication skills and telephone etiquette

+ 2+ years of experience with MS programs including Excel and Word

+ If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas, In addition, employees must comply with any state and local masking orders.

**Preferred Qualifications:**

+ Experience with RxClaims

+ Experience with Pharmacy Benefit Management (PBM) experience

**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. At this time, 90% of our non-clinical workforce transitioned to a work at home (remote) status. 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 at: click here (https://www.unitedhealthgroup.com/newsroom/addressing-covid.html) .

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

**_Colorado Residents Only:_** _The hourly range for Colorado residents is $15.00 to $22.02. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance._

_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: UnitedHealth Group; Optum, Associate Provider Service Representative, Word, Excel, Managed Care, Medical Insurance, remote, PBM, RxClaims, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #RPO#LI-Remote  

Keywords: HiringLogistics.com, Schaumburg , Associate Provider Services Representative - Remote, Other , Schaumburg, Illinois

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