Credentialing Representative

Are you a detail-oriented and highly organized individual with a passion for ensuring accuracy and compliance? Are you looking for a dynamic and fast-paced work environment where you can utilize your skills and make a difference in people's lives? UnitedHealth Group is seeking a dedicated Credentialing Representative to join our team. In this role, you will play a crucial role in the credentialing process for our network of healthcare providers, ensuring that they meet all necessary qualifications and regulatory standards. If you have a background in healthcare administration and a strong understanding of credentialing processes, we want to hear from you! Join us in our mission to help people live healthier lives and make a positive impact in the healthcare industry.

1. Manage and oversee the credentialing process for healthcare providers within the network.
2. Ensure that all providers meet necessary qualifications and regulatory standards.
3. Conduct thorough and accurate verification of provider credentials, including education, training, licensure, and certifications.
4. Maintain detailed and organized records of all credentialing activities and documentation.
5. Collaborate with internal teams and external sources to obtain and verify necessary information.
6. Communicate with providers to gather any missing or additional information needed for credentialing.
7. Monitor and track provider expirations and ensure timely renewal of credentials.
8. Stay up to date on industry regulations and changes in credentialing standards.
9. Identify and report any potential issues or concerns with provider credentials.
10. Assist in developing and implementing policies and procedures related to credentialing.
11. Provide excellent customer service to providers and internal teams, addressing any questions or concerns in a timely and professional manner.
12. Ensure accuracy and compliance with all applicable laws and regulations.
13. Collaborate with team members to continuously improve and streamline the credentialing process.
14. Participate in ongoing training and development to maintain knowledge of credentialing best practices.
15. Contribute to a positive and collaborative team environment, working together towards the common goal of improving healthcare for individuals and communities.

According to JobzMall, the average salary range for a Credentialing Representative in Eden Prairie, MN, USA is $50,000 - $60,000 per year. This may vary depending on the specific job responsibilities, experience level, and qualifications of the individual.

UnitedHealth Group Incorporated is an American for-profit managed health care company based in Minnetonka, Minnesota. UnitedHealth Group, Inc. provides health care coverage, software and data consultancy services. It operates through the following segments: UnitedHealthcare, OptumHealth, OptumInsight, and OptumRx. The UnitedHealthcare segment utilizes Optum's capabilities to help coordinate patient care, improve affordability of medical care, analyze cost trends, manage pharmacy benefits, work with care providers more effectively, and create a simpler consumer experience.