25 days old

Appeals Representative - US Remote - 919687

Dallas, TX 75201 Work Remotely
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  • Job Code
    919687

Energize your career with one of Healthcares fastest growing companies.

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You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, its a dream that definitely can come true. Already one of the worlds leading Healthcare companies,UnitedHealth Groupis restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

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This opportunity is with one of our most exciting business areas:Optum a growing part of our family of companies that makeUnitedHealth Groupa Fortune 10 leader.

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Optumhelps 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 goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

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This position is full-time (40 hours/week) Monday - Friday. Employees are required to work our normal business hours of 8:00am 5:00:pm.

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

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Training will be conducted virtually from your home.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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Primary Responsibilities:

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  • Triage requests into correct categories
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  • Document request as A&G Correspondence or A&G Appeal
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  • Ensure accurate data entry
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  • Prioritize work based on due date and run applicable work list reports to monitor workload
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  • Plans, prioritize, organize and complete work to meet established and required timeframes
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  • Determine if appeal is clinical or administrative
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  • Ensure correct letter template is utilized
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  • Complete template with appropriate information and rationale
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  • Select correct attachment and / or enclosure(s) and add to template
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  • Send out completed written notification as indicated under appeals policies
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  • Solves moderately complex problems on own
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  • Works with team to solve complex problems
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  • Supervision / guidance is required for higher level tasks
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Youll 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.

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Required Qualifications:

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  • High School Diploma / GED (or higher)
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  • Experience with Microsoft Excel (ability to create, edit, copy, send and save spreadsheet), Microsoft PowerPoint (ability to create, edit, copy, send and save presentations), Microsoft Word (ability to create, edit, copy, send and save documents) and Microsoft Outlook (ability to create, edit, copy, send and save correspondence)
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  • Strong data entry skills
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  • If you need to enter a work site for any reason, you will berequiredto screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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Preferred Qualifications:

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  • Some College (or higher)
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  • Experience withISET, ICUE and/or LINX
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  • Familiarity with Managed Behavioral Health Terminology
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  • Behavioral Health Claims experience
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Soft Skills:

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  • Must have exceptional multi - tasking skills with the ability to prioritize tasks
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  • Ability to handle a fast pace, deadlines, and competing priorities
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  • Effective interpersonal skills, flexibility and ability to handle change
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  • Ability to work independently as well as a member of the team
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  • Excellent verbal, written, computation and organizational skills
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UnitedHealth Group is an essential business.The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

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You can learn more about all we are doing to fight COVID-19 and support impacted communities at:https://www.unitedhealthgroup.com/newsroom/addressing-covid.html

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Careers with Optum.Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to doyour life's best work.

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Colorado Residents Only: The hourly range for Colorado residents is $15.00 to $25.19. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As 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.

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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.

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UnitedHealth Groupis a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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Keywords: administrative, analytical, triage, claims, United Healthcare, Optum,work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, RPO

Posted: 2021-03-24 Expires: 2021-04-23

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Appeals Representative - US Remote - 919687

UnitedHealth Group
Dallas, TX 75201

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