Provider Services Coordinator - Chino Hills, CA

Company: UnitedHealth Group
Location: Ontario
Posted on: March 24, 2020

Job Description:

Position Description
It's that time, isn't it? You're ready for the next step forward and an opportunity to build on your skills. And it just so happens that there's never been a better time to become a part of the team at UnitedHealth Group. We're driving even higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your knowledge of insurance claims and customer service to help create strong relationships with the providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

Directly responsible for all provider services support functions in the local market place representing the organization and functioning as a key member of the local field office. Working directly with the local Provider Service Representatives (PSR) to add maximum value to the IPA physicians. Provider Service Representative in training and able to assume PSR floater role within six months of assuming PSC position.

Primary Responsibilities:
Maximizes the efficiency and effectiveness of the Provider Service Representatives job duties by providing internal support of key functions. Manage all PSR reports and provider analysis requirements for the Executive Director and local market PSRs based on guidelines established, including management of external report generation and distribution. Ensure accurate monthly capitation payments to the providers including management of capitation deducts. Compile individual provider quality performance incentive information to assure maximum compliance and optimization of provider incentives. Manage external provider education meetings as established in guidelines including but not limited to orientations and office manager meetings. Manage provider contracts, LOAs, and MOUs as deemed appropriate by the Executive Director, including tracking of credentialing and contract documents. Train with PSRs on their job duties to provide ability to assume PSR role in the future and to provide coverage when PSRs are unavailable (i.e. PTO, sick days, etc.). Assist in end-to-end provider claims resolution and Pre-check Run Reviews and assist Providers with claims concerns Monitor utilization of resources for department by coordinating ordering of all supplies Responsible for monitoring office equipment repair & maintenance scheduling Act as go-between for providers if they have issues with the NAMM Provider Portal, including account setup and maintenance. Triage provider and office related issues for guidance Manage & coordinate any new projects or initiatives as directed by management
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
1 - 2+ years of experience in any of the following areas: Administrative Assistant experience supporting multiple individuals Customer Service in a professional office environment Healthcare industry experience Intermediate Outlook Calendar skills for setting up meetings with multiple participants Intermediate proficiency in Excel and Word

Preferred Qualifications
2+ years' experience in Managed Care Claims or Medical Billing experience a plus Knowledgeable in CPT and ICD-10 codes Trustworthy and able to maintain confidentiality at all times Individually identifies and resolves problems effectively and in a timely manner Able to prioritize multiple tasks Excellent people skills. Ability to interact professionally with peers, management, providers, and vendors Excellent organizational and communication skills in a high paced environment.

The health system is moving ahead. You can too as you help us build new levels of provider network performance. Join us. Learn more about how you can start doing 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: Healthcare, Provider Services, Executive Admin, administrative, filing, appointments, scheduling, agenda, expense reports, correspondence, Excel, PowerPoint, Chino, CA, California

PandoLogic.Category: Marketing & Biz Dev, Keywords: Provider Relations Representative

Keywords: UnitedHealth Group, Ontario , Provider Services Coordinator - Chino Hills, CA, Other , Ontario, California