Provider Service Representative

UnitedHealth Group - Oklahoma City, OK3.6

Full-timeEstimated: $65,000 - $87,000 a year
Save
EducationSkillsBenefits
Energize your career with one of Healthcare’s fastest growing companies.

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

It's that time, isn't it? You're ready for the next step forward and an opportunity to build on your skills. And it just so happens that there's never been a better time to become a part of the team at UnitedHealth Group. We're 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 5 leader.

Taking a giant leap step forward comes with great challenge. You'll ensure provider service quality by making outbound calls to obtain data and verify information with providers as well as perform analysis and develop reports that help clarify operational issues and opportunities.

Positions in this function are accountable for the full range of provider relations and service interactions within UHG, including working on end – to – end provider claim and call quality, ease of use of physician portal and future service enhancements, and training & development of external provider education programs. Designs and implements programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Directs and implements strategies relating to the development and management of a provider network. Identifies gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs. May also be involved in identifying and remediating operational short - falls and researching and remediating claims. Employees in jobs labeled with "SCA" must support a government Service Contract Act (SCA) agreement.

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

Moderate work experience within own function

Some work is completed without established procedures

Basic tasks are completed without review by others

Supervision / guidance is required for higher level tasks

Required Qualifications

High School Diploma / GED (or higher)

2+ years of managed care, pharmacy (including retail) or medical insurance experience

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

Proficiency with Microsoft programs including Microsoft Excel (create spreadsheets) and Microsoft Word (send emails, create documents)

Preferred Qualifications:
Microsoft Access (ability to create templates)

Soft Skills:
Proven oral communication skills including telephone etiquette

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.

If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life’s best work.SM

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: Customer Service, Customer Relations, Call Center