25 days old

Provider Services Coordinator - Chino Hills, CA

Chino Hills, CA 91709
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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.

Posted: 2020-03-11 Expires: 2020-04-10

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Provider Services Coordinator - Chino Hills, CA

UnitedHealth Group
Chino Hills, CA 91709

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