Provider Installation Representative - Ontario, CA

    • Ontario, CA

Position Description
What's most important to you in building your career and your future? Impact? Purpose? Potential? In that case, you're in the right place. UnitedHealth Group is a Fortune 6 leader in health care and an innovative driver of change in how the health system performs. As we continue to build and manage provider networks to serve our patients and families, we need to be sure that we're covering all aspects of the relationship. In this role, you'll use your strong customer service focus to help us install and manage accurate provider contracts within various United Health Group systems. It's impact, potential and purpose all in a day's work.

Position is responsible for managing updates in the claims administration software. Includes complex provider, ancillary, health plan contracts and member health plan benefit interpretation and system configuration

Primary Responsibilities:

  • Interpret provider and ancillary contracts
  • Interpret member health plan benefits
  • Identify and configure necessary additions, changes and deletions to new and existing configuration design
  • Assist Claims and Eligibility EDI providing necessary support and trouble shooting of configuration maintenance
  • Perform data entry into Claims management software and other Microsoft Applications. (Access, Excel, etc)
  • Organize and maintain assigned workload
  • Available to travel to corporate office and other locations as required
  • Other duties as assigned
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)
  • 1+ years of Health Plan or Managed Care claims experience
  • Knowledge of CPT, ICD-10, HCPCs and Revenue codes
  • Proficient in Microsoft Word, Outlook, Excel and Access
  • Professional Claims Processing
  • Knowledge of Medicare guidelines and reimbursement methods
Preferred Qualifications:

  • Institutional Claims processing
  • Knowledge of provider, ancillary and health plan contracts
  • Claims administrative software
Building out the best provider networks and leveraging their strengths will ensure that UnitedHealth Group provides better care for more people for years to come. Join us. Learn more about how you can start doing your life's best work.SM

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

North American Medical Management , California, Inc. (NAMM) develops and manages clinician networks, offering a full range of services to assist physicians and other clinicians in their managed care and business operations. For over 17 years, NAMM has been an innovator in health care with a track record for quality, financial stability, extraordinary services and superior electronic capabilities. Prime Care Medical Network is a key affiliate.

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Claims Representative, Chino hills, rancho cuca, Ontario, CA, California


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