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Clinical Appeals RN Work from Home - Full-time / Part-time
| Hours | Full-time, Part-time |
|---|---|
| Location | Phoenix, AZ Phoenix, Arizona |
About this job
The position is responsible for handling clinical reviews for Medicare member appeals within the 72 hrs AND 30 days timeframe required for appeals cases. This position is crucial for the A&G clinical team to maintain the TAT associated with the clinical reviews on all appeals and grievances and ascertain that members receive requested care when medically appropriate, in order to comply with CMS guidelines pertaining to the clinical review functions within A&G (CMS Chapter 13)
Requirements
Basic Requirements:
RN with unrestricted license
Assets Preferred:
-Appeals experience strong preferred
-CPT and/or ICD9 experience is preferred
-Managed care experience is strongly preferred
-Utilization review and/or case management experience is preferred
-Previous experience in a telephonic role
Current, active license in state of residence
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 17 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 do your life's best work.SM
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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