Provider Service Representative - Irvine, CA
Monarch HealthCare - Irvine, CA

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Position Description:

The Provider Service Representative is responsible for assisting in the full range of provider relations and service interactions within UnitedHealth Group, including working on end-to-end provider claim and call quality, ease of use of physician portal and future service enhancements, and training and development of external provider education programs. Provider Service Representatives assist in the design and implementation programs to build and nurture positive relationships between the health plan, providers (physician, hospital, ancillary, etc.), and practice managers. Other responsibilities include supporting those who direct and implement strategies relating to the development and management of a provider network, identify gaps in network composition and services to assist the network contracting and development staff in prioritizing contracting needs, and may also be involved in identifying and remediating operational short-falls and researching and remediating claims.

Primary Responsibilities:

  • Apply knowledge/skills to activities that often vary from day to day.

  • Demonstrate a moderate level of knowledge and skills in own function.

  • Require little assistance with standard and non-standard requests.

  • Solve routine problems on own.

  • Work with supervisor to solve more complex problems.

  • Prioritize and organize own work to meet agreed upon deadlines.

  • Work with others as part of a team.

  • Associate's Degree OR 1+ years of healthcare industry experience required.

  • Ability to create, maintain, and manipulate spreadsheets in MS Excel required.

  • Ability to create and edit documents in MS Word required.

  • Proficiency in MS Outlook preferred.
  • Medical insurance experience preferred.
  • Ability to work independently and remain on task.
  • Good organization and planning skills.
  • Strong interpersonal and oral communication skills including telephone etiquette.

OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Skills / Requirements See above

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