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Clinical Appeals Reviewer - Schaumburg, IL
| Hours | Full-time, Part-time |
|---|---|
| Location | Schaumburg, IL Schaumburg, Illinois |
About this job
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 people. We dream of giving you the opportunity to
do just this. And with the incredible growth of our business, it's a
dream that definitely can come true. Already 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 lives. We 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 17 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 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, and Performance.
In this position you will be making Outbound calls to Members and/or Providers regarding the Appeals process (Appeals process - process of requesting a formal change to an official decision regarding Insurance coverage). You will make your calls through a queue. You will provide expertise or general support in reviewing, researching, investigating, negotiating, and resolving all types of Appeals and Grievances. You will communicate issues, implications, and decisions with appropriate parties. You will then analyze and identify trends for Appeals and Grievances.
Requirements
- High School Diploma/GED.
- Basic (or higher) level of Computer skills, including creating and saving documents with Word, sorting, filtering, and plugging in data with Excel, and sending and receiving emails, as well as setting appointments with Outlook.
- 1+ year of experience working in a professional Team environment.
- 1+ year of professional experience dealing with Medical Insurance.
- 1+ year of experience using a telephone and computer as the primary instruments to perform the job duties.
- Bachelor's Degree.
- Call Center experience.
- Any Appeals experience.
At
Optum, you will perform within an
innovative culture that's focused on transformational change in the Healthcare
system. You will leverage your skills across a diverse and multifaceted
business. And you will make contributions that will have an impact that's
greater than you've ever imagined.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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