[Hiring] Clinical Claims Review RN @UnitedHealth Group

Role Description

As a SSBV Clinical Claims Review RN, you can put your skills and talents to work in a multifaceted role that is highly rewarding. You will be accountable for making decisions that directly impact our members while managing a demanding case load in a rapidly changing, production-driven environment.

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Perform administrative reviews of short stay inpatient hospital claims in accordance with Federal, State and client specific requirements
• Responsible for documentation of all determinations
• Maintain accurate use of screening criteria

Qualifications

• Associate's degree
• Current and unrestricted RN license in the state of residency
• 5+ years of clinical documentation experience
• 3+ years of experience as an RN, including inpatient/acute setting
• Intermediate level of proficiency in Microsoft Office (to include Microsoft Excel and One Note)
• Intermediate level of proficiency in writing
• Designated home office workspace with access to install secure high-speed internet via cable/DSL

Requirements

• Undergraduate or higher degree (preferred)
• A background in utilization review for an insurance company or experience in case management (preferred)
• Familiarity with InterQual and/or MCG Care Guidelines (preferred)
• Critical thinking skills (preferred)

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)