UnitedHealth Group Provider Relations Advocate - Cypress, CA in Orange, California

The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Provider Relations Advocate role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. We’re building better, more effective provider networks every day. In this role, you’ll use your strong customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you’ll discover the impact you want and the resources, backing and opportunities that you’d expect from a Fortune 5 leader.

Primary Responsibilities

  • Assist in end-to-end provider claims and help enhance call quality

  • Assist in efforts to enhance ease of use of physician portal and future services enhancements

  • Contribute to implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers

  • Help implement training and development of external providers through education programs

  • Occasionally help to identify gaps in network composition and services to assist network contracting and development teams

  • Participate in identifying and remediating operational short-falls and researching and remediating claims

Required Qualifications

  • Undergraduate degree or equivalent combination of education and relevant experience

  • 2+ years of health insurance industry experience

  • Proficiency in claims processing and issue resolution

  • Demonstrated working knowledge of Medicare, HMO, fee for service, and delegated / capitated model reimbursement methodologies

  • Ability to prioritize and meet deadlines from multi-staff members within the department

  • Proficiency with MS Word, Excel, PowerPoint

  • Able to commute daily to the Cypress, CA, office and willing to travel throughout Southern California for occasional daytime meetings with business partners and medical groups

Preferred Qualifications

  • Previous experience with at least one of the following systems/platforms such as NDB, Phycon, Impact, NICE, and/or UNet

  • Exceptional presentation, written and verbal communication skills

  • Ability to work independently and remain on task

  • Good organization and planning skills

Careers with UnitedHealthcare . Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

Diversity creates a healthier atmosphere: 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.

Job Keywords: provider relations, provider advocate, managed care, California, Southern California, claims, issue resolution, health care