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Provider Data Specialist - PICK DBM - National Remote

Remote, USA Full-time Posted 2025-05-22

Job title: Provider Data Specialist - PICK DBM - National Remote in Richardson, TX at UnitedHealth Group


Company: UnitedHealth Group


Job description: 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 to start Caring. Connecting. Growing together.In Provider Pick, the Provider Data Specialist or Data Loading Analysts (DLA) is a challenging one. One must have the ability to thoroughly review, analyze, and research complex health care claims to ensure claims are paid timely and accurately. Additionally, DLAs are responsible for various loading activities related to the provider network database (NDB). DLAs make informed decisions to deliver quality results and are responsible for properly maintaining the provider data housed in our core systems to allow for proper claim payment.You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
  • Assist in the processing of claims by applying a valid provider ID to claims on appropriate claims platforms
  • Apply business strategies, rules, and procedures as appropriate (e.g., determine correct system updates and correct provider ID to apply to claim)
  • Resolve provider database issues such as addresses, user warnings, demographic errors, etc. and make corrections as needed
  • Load and maintain non-par provider records in NDB to ensure accurate claims processing
  • Receive data from multiple inbound sources (e.g., spreadsheets, email, EWD, NDM, etc.)
  • Utilize database systems and tools to enter and/or research provider data (e.g., NDB; CSP FACETS, COSMOS, etc.)
  • Contact providers to verify/clarify data and gather W9 and licensing information as needed
  • Consistently meet target production, quality, and time utilization metrics
  • Take responsibility by completing assignments in a timely and accurate manner
  • Communicate effectively with business partners to resolve claims and provider data discrepancies
  • Handle any escalated issues as directed by leadership
  • Maintain current knowledge of business strategies, rules, and procedures (e.g., attend training)
  • Participate in assigned ad hoc projects
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 provider data experience
  • 1+ years of data entry experience
  • 1+ years of customer service experience
  • 1+ years of experience utilizing Microsoft Office and computer navigation skills
  • Presently employed within UHC Operations & Experience - Provider Data Operations (PDO)
Preferred Qualifications:
  • 1+ years of experience in the healthcare industry
  • CSP Facets, COSMOS, UNET or other claims processing system experience
  • Experience in a medical office setting or a corporate environment
  • Experience with medical claims
  • Experience working in an environment that includes having accountability for meeting metrics
  • Knowledge of medical terminology and managed health care
  • Adept at utilizing dual monitors to compare data stored within multiple systems
Soft Skills:
  • Demonstrated communication and organizational skills
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.For more information on our Internal Job Posting Policy, .The salary range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.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.UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.#RPO #Green


Expected salary: $16.88 - 33.22 per hour


Location: Richardson, TX


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