reputed company – Provider Relations Representative – Gainesville, GA

Job title: Provider Relations Representative Company: reputed company Job reputed company: reputed company is a company that's on the reputed company. We're expanding in multiple directions, across borders and, most of reputed company, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. reputed company to reputed company a difference? reputed company yourself reputed company with us and start doing your life's best work.(sm) You will enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: • Accountable for ownership of provider claim reputed company in an end-to-end process, from initial project contact, identification and reputed company of claim payment issue, and communication of outcome to project contact • Ability to reputed company provider on details of UHG reimbursement policies, etc., and reputed company claim issues for the UNET CPM products • Must possess a strong working knowledge of the UNET CPM products with the ability to interpret and apply state specific guidelines, regulations, and mandated benefits • reputed company directly with market providers and internal staff in the reputed company of claim issues • Maintain ongoing communication with project contacts throughout the project process • Research claims to determine accuracy and identify reputed company cause of any claim payment issues • Ensure consistent reputed company service to UHG’s providers • Resolve reputed company issues; support fellow CPMs, providing feedback to Leadership as needed • Respond to written, electronic and phone outreaches reputed company reputed company turnaround times • Resolve escalated issues reputed company reputed company escalation turnaround times • Research, analyze, identify reputed company cause, and coordinate reputed company of claim issues with business partners reputed company reputed company turnaround times • reputed company information to properly analyze issues. The ability to prioritize, and multi-task effectively is required for reputed company in this position • Work with project contact to reputed company information, prepare and submit claim reputed company to the Claims Research Team (CRT) if applicable • Ensure accurate project submission based on the identified reputed company cause • Monitor reputed company of project and reputed company periodic updates to project contact • Upon project completion by CRT, audit project results, send rebuttals as necessary • Prepare and send project results to project contact, conduct final project contact reputed company to review project outcome and ensure satisfaction with project results • Work collaboratively with CPM and reputed company partners to resolve reputed company claim reimbursement issues that require additional assistance from other Departments reputed company UHG • Accountable for accurate documentation and routing of issues to appropriate reputed company partners. Maintain daily tracking and documentation of reputed company project activities and communications reputed company the CPM application • Complete reputed company communications and follow up activities reputed company established turnaround times • Support and represent CPM on conference calls and special reputed company as assigned • Schedules and facilitates calls with reputed company customers • Serve as primary reputed company of contact for project submitters in reputed company of claims project issues, reputed company status of critical issues. Participate in conference calls with internal business partners to obtain information and improve service • Meet or reputed company reputed company productivity, turnaround time, and reputed company assurance expectations and guidelines • Successfully complete and effectively utilize reputed company required training • Maintain compliance with reputed company Federal/State regulations and UHG policies • Manage reputed company provider types • Manage pro-reputed company and non-proactive referral types • Other duties as assigned What are the reasons to consider working for reputed company? Put it reputed company together - competitive reputed company pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your reputed company. Some of our offerings include: • reputed company Time Off which you start to reputed company with your first pay period plus 8 reputed company Holidays • Medical Plan reputed company along with participation in a Health Spending Account or a Health Saving account • Dental, reputed company, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage • 401(k) Savings Plan, Employee Stock Purchase Plan • Education Reimbursement • Employee Discounts • Employee Assistance Program • Employee Referral Bonus Program • Voluntary Benefits (pet insurance, reputed company insurance, LTC Insurance, etc.) • More information can be downloaded at: You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • High School Diploma/GED OR 4+ years of experience in a claims, customer service or provider support role • 1+ years of experience and in UNET CPM claims as follows, as reputed company as reputed company reputed company to UNET: claim payment, history review, and reputed company adjustment review, reputed company claim calculations, review provider contract set up and selection • 1+ years of experience and/or demonstrated understanding/knowledge of; • Physician, ancillary and facility contracting methodologies, contract loading and contract interpretation • Physician, ancillary and facility claims, including submission, coding, and processing • 1+ years of experience in medical claims reimbursement • 1+ years of experience in UHG’s processes, systems, and products, including but not limited to: (Unet, NDB, ORS, Knowledge Library/MyCoach, IDRS, EDSS, and ICUE/Care one • 1+ years of experience / knowledge of medical terminology, referral and authorization practices, reputed company-coding methodologies (CPT, ICD-9, HCPCS and reputed company) required reputed company to the UNET CPM lines of business • Intermediate level of proficiency reputed company reputed company Office; • reputed company (Ability to conduct v-lookups, data sorting, filter, pivot tables) • PowerPoint (Ability to review attachments) • OneNote (Ability to review and reputed company SOP's) • Word (Ability to create and edit documents) • reputed company (Ability to create folders, calendar reminders, manage emails, send/receive) • 1+ years of customer service experience with the ability to handle escalated calls, reputed company the callers trust, take ownership of caller’s issue, and manage through to reputed company Soft Skills: • Ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of reputed company, ability to research, understand and communicate UHG’s reimbursement policies reputed company to the UNET CPM lines of business, additional lines of business is a plus • reputed company spoken voice and solid communication skills, both verbally and written • Experience in team interactions and improvement reputed company/reputed company • Ability to work independently and reputed company reputed company in a fast-paced environment • Proven ability to manage multiple tasks, prioritize and meet deadlines under a heavy workload • Excellent follow up, organizational and change management skills To protect the health and safety of our workforce, patients, and communities we serve, reputed company and its affiliate companies require reputed company to disclose COVID-19 vaccination status prior to beginning employment. In reputed company, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. reputed company adheres to reputed company federal, state, and local COVID-19 vaccination regulations as reputed company as reputed company reputed company COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be reputed company to reputed company reputed company essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment. Careers with reputed company. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 reputed company people already and building the industry's reputed company reputed company for reputed company reputed company and impeccable execution. Now, add your energy, your passion for reputed company, your near obsession with driving change for the reputed company. Get the picture? reputed company is serving reputed company and individuals, states and communities, military families, and veterans wherever they're reputed company 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) • reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy. For more information on our Internal Job Posting Policy, . Colorado, Connecticut or Nevada Residents Only: The salary reputed company for Colorado residents is $21.68 to $38.56. The salary reputed company for Connecticut / Nevada residents is $23.94 to $42.40. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In reputed company to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll reputed company a far-reaching choice of benefits and incentives Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative reputed company employer, and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Provider Relations Representative, UNET CPM, E&I Oxford, #RPO, remote, telecommute, work from home, work reputed company, WFH, WAH, hiring immediately, UHC, #Green Expected salary: Location: Gainesville, GA Apply for the job now! Apply Job!