Senior Clinical Appeals Reviewer – Multiple Locations - Full-time / Part-time

Position Description:
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 14 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.Employees in this function are responsible for providing expertise or general support in reviewing, researching, investigating, negotiating, and resolving all types of Appeals and Grievances. Communicates issues, implications, and decisions with appropriate parties. Analyzes and identifies trends for Appeals and Grievances. This includes senior-level positions with education/certification/licensure other than an RN, such as BSW, MSW, DDS, Chiropractor, Physical Therapist, etc. (Positions responsible for Claims Appeals can be found in the Claims job family.)

Primary Responsibilities:

Extensive work experience, possibly in multiple functions. 
Work does not usually require established procedures.
Work independently.
Mentor others.
Act as a resource for others.
Coordinate others' activities.
***Position can be located in: San Francisco, CA, Duluth, MN, St. Louis, MO, Schaumburg, IL, and Philadelphia, PA

Required Qualifications:

High School Diploma/GED.
2+ years of Telephonic Customer Service experience.
2+ years of Healthcare Insurance experience.
1+ year of professional Appeals experience.
Knowledge of Medical Terminology.
Previous experience working with Microsoft Office products.
Preferred Qualifications:


Bachelor's Degree.
Experience in a professional Leadership role.
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 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, 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.