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.
As a Clinical Appeals Reviewer the key component of the role is to have the ability to work on your own, stay focused in a home environment, think outside of the box and good with researching. You must be an independent, self-starter, reliable and able to adapt to change. This is a remote position working from home in a designated area without distractions and confidentiality. Telephone intake to make calls, gather information and occasional outbound calls for research and medical records. Several processes and systems are used to process data, technical savvy to transition between systems. Staff is required to take their lunch and be back online working within two hours remaining in the day. Training will be remote and approximately for three months with support from the Sr. Coordinators and Supervisors to be assist with questions or concerns.
This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9:00am – 6:00pm CST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime or weekends.
We offer remote training for minimum of 3/4 months must be available for entire ¾ months with no extensive vacation during training; attendance is required. 1st week with Sr. Coordinator for technical set-up, 2nd week with National Training Team for a high overview of dept. & systems. Remaining of three months working hands-on learning, observation, and shadowing. The hours during training will be 7am to 6pm CST, Monday – Friday.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Applies knowledge/skills to a range of moderately complex activities.
Demonstrates great depth of knowledge/skills in own function.
Sometimes acts as a technical resource to others in own function.
Proactively identifies solutions to non-standard requests.
Solves moderately complex problems on own.
Works with team to solve complex problems.
Plans, prioritizes, organizes and completes work
May need to contact providers via phone or email to request additional documentation or clarification as needed.
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 equivalent work experience
Must be 18 years of age OR Older
1+ years of previous or current medical customer service experience that included making call/ emailing patients and providers
2+ years of Healthcare Insurance Appeals experience (i.e. researching appeals)
Ability to work any of our 8-hour shift schedules during our normal business hours of 9:00am – 6:00pm CST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime or weekends
Preferred Qualifications:
Experience with ATS, iCare, ETS, HSR, UNET, ISET, CIRRUS
Intake experience
Telecommuting Requirements:
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.54 to $32.55 per hour. 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.
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.
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.
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UnitedHealth Group
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