Credentialing Representative
@ UnitedHealth Group

Eden Prairie, Minnesota, United States
On Site
Full-time
Posted 2 days ago

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XXXXXXXX XXXXXXXXX XXXXXX***** @unitedhealthgroup.com
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Job Details

About UnitedHealth Group

Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. At UnitedHealth Group, you will directly improve health outcomes by connecting people with essential care, pharmacy benefits, data, and resources.

Role Overview: Credentialing Representative

This role is remote and part of a team that drives health optimization on a global scale. You will work with medical coding, compliance workflows, regulatory guidance, and credentialing processes to support healthcare providers.

Primary Responsibilities

  • Utilize reference materials and online sources to identify medical codes.
  • Apply medical coding knowledge and reference guidelines to assign codes.
  • Review clinical documentation and query providers for clarifications.
  • Manage multiple work demands to meet productivity and turnaround standards.
  • Handle regulatory guidelines and resolve coding edits or denials.
  • Navigate clinical software applications and maintain professional certifications.

Benefits & Perks

Enjoy a competitive base pay, comprehensive benefits including PTO, health plans, dental, vision, 401(k), employee stock purchase program and more. UnitedHealth Group supports career development and rewards performance in a collaborative environment.

Required Qualifications

  • High School Diploma/GED (or higher)
  • 2+ years of healthcare provider credentialing experience
  • Experience with compliance workflows and NCQA policies
  • Proficiency in researching and applying government regulatory information
  • Intermediate skills in MS Excel and Word
  • Strong communication, organizational and multitasking skills

Key skills/competency

  • credentialing
  • compliance
  • NCQA
  • regulatory
  • medical coding
  • healthcare
  • documentation
  • MS Excel
  • time management
  • telecommute
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How to Get Hired at UnitedHealth Group

🎯 Tips for Getting Hired

  • Research UnitedHealth Group's culture: Understand their mission and benefits.
  • Customize your resume: Highlight credentialing and compliance experience.
  • Prepare for technical questions: Focus on coding and regulatory knowledge.
  • Practice behavioral insights: Emphasize communication and time management skills.

📝 Interview Preparation Advice

Technical Preparation

Review medical coding guidelines.
Practice using clinical software tools.
Brush up on MS Excel and Word skills.
Study NCQA and regulatory standards.

Behavioral Questions

Describe work under pressure examples.
Explain independent task management techniques.
Showcase communication with healthcare teams.
Discuss time management in multitasking situations.

Frequently Asked Questions