Payer Credentialing Coordinator - Boulder, CO

Company: UnitedHealth Group
Location: Boulder
Posted on: April 4, 2021

Job Description:

Payer Credentialing Coordinator - Boulder, CO We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM 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 building and maintaining extensive provider networks to serve our customers. Our goal is to attract and secure relationships with the best in every specialty and every community. As a member of our provider credentialing team, you'll help us vet and document the competencies of physicians and other providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 7--leader. Primary Responsibilities:

• Responsible for completing the process of credentialing providers employed by the Community Medical Associates (CMA) group for Boulder Community Health as required by each payer contract and government payer regulations
• Responsible for re-credentialing providers via CAQH every 120 days to ensure provider credentialing statuses remain consistent.
• Coordinate with BCH Medical Staff Office to ensure all applicable documents are acquired for timely credentialing of providers.
• Communicate with representatives from managed care organizations and the BVIPA to update physician roster lists when appropriate.
• Update and communicate provider credentialing status when employment termination occurs
• When necessary, work collaboratively with hospital reimbursement specialists to update Medicare 855A forms.
• Maintain and update Medicare 855B enrollment for CMA group locations and providers
• Update Provider Enrollment, Chain and Ownership System (PECOS) and National Plan & Provider Enumeration System (NPPES) when appropriate.
• Set meetings with providers to complete necessary credentialing paperwork or acquire necessary signatures when needed.
• Maintain the confidentiality of all verbal and written communications and all collected data, as appropriate
• Serve as an educational resource to providers and staff concerning credentialing activities
• Serve as the primary liaison between billing staff and payers when reimbursement issues arise due to credentialing activities
• Update and maintain timely credentialing matrix for providers and staff to have an accurate picture of current credentialing activities and status
• Communicate with IT analysts and Billing Office staff when provider statuses change in order to facilitate correct billing.
• Creates ad hoc reports upon request from Director of Physician Revenue Cycle, Physician Billing Manager, Compliance Department, or Medical Staff Department
• Participates in department and hospital committees/projects as needed/requested
• Attends appropriate continuing education seminars
• Meets monthly with Director of Physician Revenue Cycle and Physician Clinics Billing Manager to give updates on credentialing activities
• Consistent and on time attendance is an essential function of position
• Employees are expected to comply with all regulatory requirements, including Joint Commission Standards 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 above
  • 2+ years of experience with physician and\or hospital billing or working in a healthcare related setting--
  • 1+ years experience in credentialing providers, working in provider relations, medical billing or quality management
  • Proficiency with MS Word, Excel, Outlook, and other Microsoft Office applications
  • You will be asked to perform this role in an office setting or other company location
  • 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. 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. 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. Colorado Residents Only: The hourly--range for Colorado residents is $15.00--to $25.19. 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. We want you to know what our hiring process looks like. Watch the video and find out what to expect along the way. Getting an internship UnitedHealth Group is not only an opportunity to do something extraordinary with your summer, it's also an opportunity to land your first full time job. Most college students know the last internship before graduation is perhap--- So you've searched our open jobs and are ready to submit your application. But how do you know if a specific job is right for you? Here are four questions to consider before applying--- Here at UnitedHealth Group, we've adjusted the way we work as a result of COVID-19. At this moment, 90% of our non-clinical staff is working from home around the globe, prior to COVID-19 42% of our non-clinical staff was already working from home. Th--- UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-800-561-0861 and press or say 1 for Applicant to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday. UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc. 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, Boulder , Payer Credentialing Coordinator - Boulder, CO, Other , Boulder, Colorado