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UnitedHealth Group: Senior Appeals Representative – Oldsmar, Fl, Tn, Hi Or Remote

UnitedHealth Group

This is a Contract position in Holiday, FL posted November 20, 2020.

Let’s talk about diplomacy.

Let’s talk about accuracy.

Let’s talk about howUnitedHealth Groupbecame a Fortune6leader in healthcare.

We did it by working to become an undisputed leader in creating service quality and helping to improve the lives of millions.

Now, here’s where you come in.

You can build on your problem solving skills by taking on responsibility for reviewing, researching, investigating and triaging claims that were denied to determine their correct status.

You’ll drive the action and communicate with appropriate parties regarding appeals and grievance issues.

In turn, we’ll provide you with great training, support and opportunitiesThis position is full-time (40 hours/week) Monday Friday.

Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 8:00am 5:00pm).

It may be necessary, given the business need, to work occasional overtime.

Our office is located at 601 BROOKER CREEK BOULEVARD Oldsmar, FL.If you are located in the Oldsmar, FL area, or the state of Arizona or Hawaii, you may have the flexibility to telecommute as you take on some tough challenges.Training will be conducted virtually from your home.

What we do defines who we are.

Take a deeper look at how we’re providing support during this global health crisis and search for a way you can get involved.

View our Covid-19 Resources Page at: https://info.Uhg.Com/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/providersEnsure complaint has been categorized correctlyObtain additional documentation required for case reviewReview case to determine if review by clinician is requiredRender decision for non-clinical complaints using sound, fact-based decision makingComplete necessary documentation of final appeals or grievance determination using appropriate templatesCommunicate appeal or grievance information to members or providers and internal/external parties within the required timeframeThis is a challenging role with serious impact.

You’ll need strong analytical skills and the ability to effectively interact with other departments to obtain original claims processing details.

You’ll act as a subject matter expert for your team on applicable regulatory guidelines and privacy policies.

You’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 or GED OR equivalent work experience2 years of experience analyzing and solving appeals and grievances in an office environment using the telephone and computer as the primary instruments to perform job duties OR 2 years of experience in a healthcare setting with knowledge of the medical claims and/or billing processProficiency with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applicationsSoft Skills:Strong written communication skills including advanced skills in grammar and spellingAbility to multi-task, this includes the ability to understand multiple products and multiple levels of benefits within each productTelecommuting Requirements:Reside within Oldsmar, FL, Arizona or HawaiiRequired to have a dedicated workarea established that is separated from other living areas and providesinformation privacyAbility to keep all companysensitive documents secure (if applicable)Must live in a location that canreceive a UnitedHealth Group approved high-speed internet connection orleverage an existing high-speed internet serviceUnitedHealthGroup is an essential business.

The health and safety of our team membersis our highest priority, so we are taking a science driven approach to slowlywelcome and transition some of our workforce back to the office with manysafety protocols in place.

We continue to monitor and assess before we confirmthe return of each wave, paying specific attention to geography-specifictrends.

At this time, 90% of our non-clinical workforce transitioned to a workat home (remote) status.

We have taken steps to ensure the safety of our325,000 team members and their families, providing them with resources andsupport as they continue to serve the members, patients and customers whodepend on us.

Someof the steps we’ve taken to ensure employee well-being include:Transitioned our new hire training classes to be conductedvirtuallyLaunched our ProtectWell app and UnitedCARES program to helpease the burden and stress for our UnitedHealth Group team members and theirimmediate family affected by COVID-19Daily updates from our CEO Dave Wichmann to support andinspire team members during this challenging timeOnsite social distancing and increased sanitization measuresfor employees who have been welcomed back to our officesFully cover the COVID-19 healthcare costs for our employees Employees who self-identify as high risk or who live withsomeone who is high risk have been asked to remain working from homeYou can learn moreabout all we are doing to fight COVID-19 and support impacted communities at: https://www.Unitedhealthgroup.Com/newsroom/addressing-covid.HtmlUnitedHealth Groupis a team of more than 260,000 people who are building career success through commitment, compassion and a desire to make a difference.

Join us.

Learn more about how you can start doingyour life’s best work.SMCareers with UnitedHealthcare.Let’s talk about opportunity.

Start with a Fortune 6 organization that’s serving more than 85 million people already and building the industry’s singular reputation for bold ideas and impeccable execution.

Now, add your energy, your passion for excellence, your near-obsession with driving change for the better.

Get the picture?

UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they’re found across the globe.

We bring them the resources of an industry leader and a commitment to improve their lives that’s second to none.

This is no small opportunity.

It’s where you can doyour life’s best work.SMDiversity 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.Keywords Appeals, Claims, Telecommute, Oldsmar, FL, UHG, UnitedHealth Group,work at home, work from home, WAH,WFH, remote, telecommute, hiring immediately