[Hiring] Credentialing and Enrollment Specialist @UnitedHealth Group

Role Description The Credentialing and Enrollment Specialist is responsible for activities associated with credentialing or re-credentialing physicians and providers, including processing provider applications and re-applications. • Location: Remote Nationwide • Schedule: FT, 40 hrs. Monday – Friday, 8am – 5pm • You’ll enjoy the flexibility to work remotely from anywhere within the U.S. Primary Responsibilities: • Apply knowledge/skills to a range of moderately complex activities • Demonstrate great depth of knowledge/skills in own function • Sometimes act as a technical resource to others in own function • Meet with Medical Director to review initial and reappointment applications • Meet with AAAHC and State Auditors to review files • Primary Source Verification Process for initial and reappointments • Maintain expirable for all employed and non-employed clinicians at ASCs • Compile and generate Credentialing Committee Minutes • Perform internal audits on credentialing and re-credentialing files for accuracy and maintaining compliance with credentialing policies and procedures • Maintaining knowledge of and compliance with TJC, NCQA, CAQH, and CMS standards, as appropriate • Monitoring upcoming renewal dates and working with medical staff to advise them on steps to maintain their credentials • Proactively identify solutions to non-standard requests • Solve moderately complex problems on own • Work with team to solve complex problems • Presentation skills to group setting • Plan, prioritize, organize and complete work to meet established objectives • May coordinate work of other team members • Credentialing of medical group providers and hospital privileging application review and submission at the individual and group level • Complete revalidation requests with government and commercial payers • Track and maintain medical professionals’ licensure, certifications, etc. • Work with other organizational departments internal/external to ensure that credentialing efforts are in line with business objectives Qualifications • High School Diploma/GED • 3+ years of Healthcare Provider group/Facility Credentialing experience • 2+ years of experience in healthcare administration, medical staff services, health information management • 2+ years of experience with credentialing processes, medical staff privilege and knowledge of relevant software or databases used in credentialing • Intermediate level of proficiency with Microsoft Excel and Word • Ability to work Pacific time zone hours Requirements • Experience working with Compliance Workflows and Processes including AAAHC, JC, CMS, and NCQA Policies • Experience in researching and applying Government Regulatory Information • Knowledge of CAQH • Knowledge of MD Staff credentialing databases • Data analytics • Pecos enrollment • Proven ability to plan and prioritize to meet benchmarks/deadlines Benefits • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution (all benefits are subject to eligibility requirements) • Hourly pay for this role will range from $20 to $36 per hour based on full-time employment