Appeals Representative Associate - Wausau, WI - Full-time / Part-time

Position Description:Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.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:

Research and resolve written complaints and complex or multi-issue provider complaints submitted by consumers and physicians/providersCommunicate with appropriate parties regarding appeals and grievance issues, implications and decisionsAnalyze and identify trends for appeals and grievancesApply knowledge/skills to basic, repeated activitiesRespond to standard requests and solve routine problems by following established proceduresWork with others as part of a team and have work reviewed by othersLimited work experienceWorks on simple tasks using established proceduresDepends on others for guidanceWork is typically reviewed by others

Required Qualifications:

High School Diploma or GED
1+ years of Customer Service experience in a call center environment analyzing and solving customer problems or 1+ years of experience in a corporate environment
Experience with MS Excel including data entry, sorting, creating/modifying spreadsheets and MS Word including data entry and documentation creation.
Work Shift 8 hour shift/ Monday - Friday and ability to work overtime as neededPreferred Qualifications:

Experience with Healthcare/Medicare TerminologyExperience with OnBase, Redwood and/or CPS Managed Care and previous Appeals/Grievances experienceExperience with MS Access including database creation
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.
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.

 
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