Supervisor Clinical Appeals - office based in either Philadelphia, PA or St. Louis, Missouri

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
 
In this role you will be responsible for providing expertise and customer service support to members, customers, and / or providers. This includes direct phone - based customer interaction to answer and resolve a wide variety of inquiries regarding appeals and grievances.
 
Responsibilities:

Demonstrates a depth and breadth of knowledge / skills in own area and is often able to apply these outside of own function
Applies knowledge / skills to complex or escalated activities
Identifies and solves complex or nonstandard problems on own; proactively identifies new solutions to problems
Complex tasks are completed without review by others
Plans, prioritize, organize and complete work to meet established objectives
Translates concepts into practice
Assesses and interprets customer needs and requirements
Works independently
Actively participate in standardization and process improvement
Coaches, mentors, trains provides feedback, and guides others
May serve as backup in the absence of manager
Coordinates or assigns others' activities
Acts as a facilitator to resolve conflicts on team; seen as key team member on project teams spanning more than own function
Review / analyze phone support data / metrics and communicate patterns / trends to internal stakeholders, as needed (e.g., leadership, Subject Matter Experts, business partners)
Participate in customer site visits, as needed (e.g., to obtain feedback, provide education, clarify support processes, highlight company performance)

Required Qualifications:

Undergraduate degree or equivalent experience
1+ year of experience with an intermediate (or higher) level of proficiency with Windows applications, such as Microsoft Excel, Word, and Outlook
Critical Thinker
Excellent verbal, written, computation and organizational skills required
Must have exceptional multi - tasking skills with the ability to prioritize tasks
Ability to handle a fast pace, deadlines, and competing priorities
Effective interpersonal skills, flexibility and ability to handle change
Strong verbal and written documentation skills
Knowledge of Medical Terminology
Preferred Qualifications:

Experience managing in a Call Center Environment
Experience with ISET, IQ and / or UMR is highly desired
Previous experience with handling claim denials and customer escalations
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: 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.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
 
Job Keywords: Customer, Care, Appeals, Supervisor, analyze, data, Philadelphia, PA, Pennsylvania, St. Louis, MO, Missouri