Join UnitedHealth Group as an Appeals Representative, where you'll play a crucial role in reviewing and resolving appeals, ensuring compliance with regulatory standards, and positively impacting the healthcare experience for millions. Enjoy a full-time schedule with opportunities for career advancement and a supportive work environment.
Key Responsibilities
Review, research, investigate, and resolve appeals and grievances
Ensure compliance with regulatory timelines
Prepare written outcomes and communicate with relevant parties
Analyze trends for appeals and grievances
Obtain relevant medical records and information for appeals
Document final determinations and communicate with members
Required Qualifications
High School Diploma / GED or equivalent work experience
Must be 18 years of age or older
1+ years of experience analyzing and solving appeals in the health care industry
Experience with Microsoft Office (Word, Excel, Outlook)
Ability to work any of the 8-hour shift schedules during business hours and occasional overtime
Preferred Qualifications
Experience utilizing claims platform FACETS
Experience with creating resolution letters
Experience with health care, medical, or pharmacy terminology
Experience in healthcare coding practices (CPT's, HCPCS, DRG, ICD-9, ICD-10)
Experience with healthcare business segments (e.g., Commercial, Behavioral Health)
Benefits & Perks
Comprehensive benefits packageIncentive and recognition programsEquity stock purchase401k contribution