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UnitedHealth Group Senior Provider Data Specalist in Bangalore, India

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Senior Provider Data Specialist is responsible for various activities related to the provider network database which may include any or all of the following: database maintenance, reporting and extracting data for various reports and analyses, initiating database improvement. Senior Provider Data Specialists develop and maintain standards for database integrity and quality assurance, coordinate corrective activities to clean database and retain users, and manage communication processes with other departments regarding database improvements. Other responsibilities include conducting audits and providing feedback to reduce errors and improve processes and performance, maintaining current provider data to ensure the quality of the network, and may be responsible for representing the provider network area on company IT projects, reporting and tracking provider calls and complaints, or for the support, coordination, and production of the paper directory cycles.

In this role you will be expected to:

  • Apply knowledge/skills to a range of moderately complex activities.

  • Demonstrate great depth of knowledge/skills in own function.

  • Sometimes act as a technical resource to others in own function.

  • Proactively identify solutions to non-standard requests.

  • Solve moderately complex problems on own.

  • Work with team to solve complex problems.

  • Plan, prioritize, organize and complete work to meet established objectives.

  • May coordinate work of other team members.

CPQ users refer PTI rules to select appropriate Individual/Group MPIN and UHCID number to claims teams/operations area for claim resolution. CPQ users will always view the claim hardcopy in Intra Document Retrieval System (iDRS) or Enterprise Data Storage System (EDSS) using the claim image number as found in NDM. users need refer Medicaid ID guidelines to update Medicaid id for listed states and document the same in COSMOS PS320 screen and NDB application. users need to correct/update Demographic and Contractual changes required for claims and transferred back to claims team for final resolution.

Requirements:

  • High school diploma

  • 4+ years experience in the healthcare industry.

  • 2+ years of data entry experience.

  • 2+ years experience in medical claims processing.

  • Intermediate level of proficiency with MS Word and Excel.

Preferred Skills:

  • Experience working with healthcare providers is preferred.

  • Customer service experience is preferred.

  • Proficiency with medical terminology preferred.

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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