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Job Details

UnitedHealth Group

Provider Service Coordinator - Hybrid role in Riverside, CA (16401303)




Full Time


Riverside, California, United States

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

Responsible for assisting providers (MD, DO, NP, PA) and patients in a medical office/clinic or specialty clinic setting. Under the supervision of the provider, the Medical Assistant performs all patient care and/or front office processes. Functions as a liaison between the providers, patients, staff, pharmacies and other facilities. It is the duty of all employees to understand and perform their job tasks to the highest level.

Primary Responsibilities:

  • Demonstrate understanding of internal claims and payment policies and procedures
  • Demonstrate understanding of systems (e.g., FACETS; ISET; Linx; vendor platforms; EDI processes; clearinghouses) in order toprovide services to providers
  • Demonstrate understanding of provider contracting (e.g., language; terminology; processes; methodology)
  • Demonstrate understanding of coding and billing, and how those apply to reimbursement policies
  • Demonstrate understanding of applicable policies and procedures that impact providers (e.g., reimbursement; claims; appeals.credentialing; complaints; medical policies; benefits design; regulatory requirements; client business rules)
  • Demonstrate understanding of fee negotiation and/or fee change protocols
  • Demonstrate understanding of company branding, service, tools, and outreach activities (e.g., policy changes, new technologiesand portals; changes to Smart Card practice)
  • Demonstrate understanding of industry-related trends and/or events (e.g., new regulations; new health-care related laws.competitive information; health care reform)
  • Demonstrate knowledge of relevant computer and software applications (e.g., MS Office; office tools; storage drives and locations)
  • Demonstrate understanding of specific internal and external market trends and current events that impact the provider community

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 or equivalent work experience
  • 2+ years of managed care or medical insurance experience
  • 2+ years Network/Physician relation experience
  • 1+ years of experience in a claim, customer service or provider support role
  • Proven oral communication skills including telephone etiquette
  • Proficiency with MS programs including Excel and Word
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualification:

  • Solid organizational Skills

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all 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 Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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.