Job details
Job type full-time
Full job description
You’ll enjoy the flexibility to telecommute* from anywhere within the u.sAs you take on some tough challenges.
Energize your career with one of healthcare’s fastest growing companies.
You dream of a great career with a great company – where you can make an impact and help peopleWe dream of giving you the opportunity to do just thisAnd with the incredible growth of our business, it’s a dream that definitely can come trueAlready one of the world’s leading healthcare companies, unitedhealth group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier livesWe live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: optum – a growing part of our family of companies that make unitedhealth group a fortune 10 leader.
Optum helps nearly 60 million americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goalsNo other business touches so many lives in such a positive wayAnd we do it all with every action focused on our shared values of integrity, compassion, relationships, innovation & performance.
This position is full-time (40 hours/week) monday - fridayEmployees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pmIt may be necessary, given the business need, to work occasional overtime.
*all telecommuters will be required to adhere to unitedhealth group’s telecommuter policy.
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
This is a challenging role with serious impactYou’ll need strong analytical skills and the ability to effectively interact with other departments to obtain original claims processing detailsYou’ll also need to effectively draft correspondence that explains the claim resolution/outcome as well as next steps/actions for the member.
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 equivalent years of work experience
1+ years of experience analyzing and solving customer problems or 1+ years of work experience in a related environment (i.eOffice, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
Proficiency with computer and windows pc applications, which includes the ability to navigate and learn new and complex computer system applications
Preferred qualifications:
Experience with health care, medical, or pharmacy terminology
Telecommuting requirements:
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Ability to keep all company sensitive documents secure (if applicable)
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 including advanced skills in grammar and spelling
Unitedhealth group requires all new hires and employees to report their covid-19 vaccination status.
Military & veterans find your next mission: we know your background and experience is different and we like thatUnitedhealth group values the skills, experience and dedication that serving in the military demandsIn fact, many of the values defined in the service mirror what the unitedhealth group culture holds true: integrity, compassion, relationships, innovation and performanceWhether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journeyLearn more at https://uhg.hr/transitioning-military
Learn how teresa, a senior quality analyst, works with military veterans and ensures they receive the best benefits and experience possibleHttps://uhg.hr/vet
Careers with unitedhealthcare Let`s talk about opportunityStart with a fortune 5 organization that`s serving more than 85 million people already and building the industry`s singular reputation for bold ideas and impeccable executionNow, add your energy, your passion for excellence, your near - obsession with driving change for the betterGet the picture? unitedhealthcare is serving employers and individuals, states and communities, military families and veterans wherever they`re found across the globeWe bring them the resources of an industry leader and a commitment to improve their lives that`s second to noneThis is no small opportunityIt`s where you can do your life’s best workSm
Colorado residents only: the hourly range for colorado residents is $15.00 to $25.19Pay is based on several factors including but not limited to education, work experience, certifications, etcAs of the date of this posting, in addition to your salary, uhg offers the following benefits for this position, subject to applicable eligibility requirements: health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; employee assistance program; pto; and employee-paid critical illness and accident insurance.
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 workplaceCandidates are required to pass a drug test before beginning employment.
Keywords: healthcare, health care, managed care, appeals, billing representative, billing, collections, claims, customer service, medical billing, work at home, work from home, wah, wfh, remote, telecommute, hiring immediately, #rpo
