Transform healthcare at Optum as a Provider Service Representative in Ontario, CA. Support provider claims and enhance relationships between health plans and medical providers.
Optum is seeking a Provider Service Representative to strengthen our provider networks. This role requires expertise in managed care, provider claims, and contract management, fostering strong ties between the health plan, providers, and practice managers. You will also assist in training external providers and identify network gaps to enhance service delivery.
Key Responsibilities:
• Assist in end-to-end provider claims processes
• Design programs to foster provider relationships
• Support provider network development and management
• Implement training programs for external providers
• Identify service gaps for network improvement
Requirements:
• High School Diploma or GED
• 3+ years in managed care or medical insurance
• 1+ years of communication experience
• Proficiency in...