Credentialing Representative
About the role
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Optum has an immediate opening for a Credential Representative - National Remote. Credential Representative - National Remote will be responsible for enrolling behavioral health providers with appropriate payers for associated entities.
Responsibilities
- Identify and document credentialing, compliance and contract requirements as they enroll in Optum Serve's network, including the creation and maintenance of practitioner records within databases
- Initiate credentialing processes, retrieve, verify/ follow up on all credentialing applications and supporting documentation needed for Optum Serve's practitioner network
- Ensure credentialing applications are complete, data integrity is intact within databases to meet requirements for primary source verification and industry standards
- Perform quality reviews on credentialing files throughout each credentialing cycle
- Monitor and facilitate complete and accurate re-credentialing of practitioners on a 3-year cycle
- Act as the liaison between the practitioner network and internal departments to troubleshoot issues or answer any questions/concerns
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