[Hiring] Appeals Representative @UnitedHealth Group

Role Description

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

This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 5:00 pm MST. It may be necessary, given the business need, to work occasional overtime.

We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities:

• Research and resolve written complaints submitted by consumers and physicians / providers
• Ensure complaint has been categorized correctly
• Obtain additional documentation required for case review
• Review case to determine if review by clinician is required
• Render decision for non-clinical complaints using sound, fact-based decision making
• Complete necessary documentation of final appeals or grievance determination using appropriate templates
• Communicate appeal or grievance information to members or providers and internal/external parties within the required timeframes

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.

Qualifications

• High School Diploma / GED OR equivalent years of work experience
• Must be 18 years of age OR older
• 1+ years of experience with analyzing and solving customer problems
• 1+ years of experience working in a remote environment
• Proficiency with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• Experience with Microsoft Word (create correspondence and work within templates) and Microsoft Outlook (email and calendar management)
• Ability to work between the hours of 7:00 am - 5:00 pm MST from Monday – Friday

Requirements

• Experience with health care, medical, OR pharmacy terminology
• Experience working with Microsoft Excel (data entry, sort / filter, and work within tables)

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

Soft Skills

• Strong written communication skills with advanced proficiency in grammar and spelling

Benefits

• Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)
• The hourly pay for this role will range from $18 - $32 per hour based on full-time employment

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.