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Senior Appeals Representative/Letter reviewer - US Telecommute or any UHG office - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Duluth, MN Duluth, Minnesota |
About this job
Position Description:
Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances. Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions. Analyzes and identifies trends for all appeals and grievances. May research and resolve written Department of Insurance complaints and complex or multi-issue provider complaints submitted by consumers and physicians/providers.
Primary Responsibilities:
Primary Responsibilities:
- Provide expertise or general claims support by reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances.
- Analyze and identify trends and provides reports as necessary
- Consistently meet established productivity, schedule adherence, and quality standards
- Provide excellent customer service
- Extensive work experience within own function.
- Work is frequently completed without established procedures.
- Works independently.
- May act as a resource for others.
- May coordinate others activities.
**** Telecommute option is only available for current telecommuters - all other requests will be on a case by case review****
Requirements
Requirements:
- High School Education/GED with some college experience
- Previous editing/proofreading experience in a school or a professional environment
- Intermediate in MS Word
- Basic in MS Outlook and Excel
- Ability to review and proofread appeals letters for grammatical and spelling errors
- Ability to work with minimal supervision
- 3+ credits in College English coursework
Soft Skills:
- Excellent written and verbal communication skills
- Minor or Major in English or Communications
- Medical Claims knowledge
- Medical Claims processing experience
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
Diversity creates a healthier atmosphere: 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.
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