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Job Details

Senior Provider Data Specialist


Clinical Data Management


Duluth, Minnesota, United States

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM

Data Loading Analysts (DLAs) are responsible for various data loading activities related to the provider network database (NDB, NICE) and synching provider data between claims payment platforms (CSP Facets). DLAs make informed decisions to deliver quality results and are responsible for maintaining the provider data standards for database integrity and quality assurance. In this role, the challenges are varied, and the pace is fast. You'll need to work independently and be a problem solver as you you'll be working with a wide range of credentialing providers as well as assisting in provider relations, medical billing, and quality management.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Utilize database systems and tools to enter and/or research provider data (e.g., NDB; CSP FACETS)
  • Receive data from multiple inbound sources (e.g., RnR, etc.)
  • Recording daily production work within the Omega application
  • Verify system results to determine whether keyed data is correct, or updates are necessary
  • Verify clean data loaded into various provider databases synchs properly between claims payment platforms
  • Research multiple databases to pull in the correct or needed information
  • Maintain current knowledge of business strategies, rules, and procedures (e.g., attend training, coaching)
  • Apply business strategies, rules, and procedures as appropriate (e.g., determine whether to reject or accept data prior to entry)
  • Participate in applicable ad hoc projects, as assigned
  • Consistently meet target production, quality, and time utilization metrics

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.

Required Qualifications:

  • High School Diploma/GED (or higher) OR 3+ years of customer service experience
  • 1+ year of customer service experience
  • 1+ year of computer experience utilizing Microsoft Office and computer navigation skills
  • 1+ year of data entry experience

Preferred Qualifications:

  • Experience with NDB database
  • Experience with CSP Facets
  • Experience with data loading
  • Extensive work experience with BSAR maintenance
  • Applies knowledge/skills to a range of moderately complex activities
  • Receive report, review, and analyze data using appropriate systems and tools (e.g., NDB; FACETS; NICE; Business Objects; RnR, etc.), and determine/implement appropriate actions
  • Analyze data to identify data anomalies and discrepancies
  • Experience with provider data (demographic and/or contractual)
  • Experience in a medical office setting or a corporate environment
  • Experience with medical claims
  • Experience working in an environment that included having accountability for meeting metrics
  • Experience with dual monitor environment
  • Demonstrated communication and organization skills
  • Experience working in telecommuting environment

Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

California, Colorado, Connecticut, Nevada, New York, Washington or Rhode Island Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, Washington or New York City residents is $18.80 to $36.78. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.