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.

Let's talk about diplomacy.  Let's talk about accuracy. Let's talk about how UNITEDHEALTH GROUP became a Fortune 10 company leader in health care. We did it by working to become an undisputed leader in creating quality service and helping to improve the lives of millions. Now, here's where you come in. You can build on your problem solving skills by taking on responsibility for reviewing, researching, investigating and triaging claims that were denied to determine their correct status. You'll drive the action and communicate with appropriate parties regarding appeals and grievance issues. In turn, we'll provide you with the great training, support and opportunities you'd expect from a Fortune 10 company. This position is full-time (40 hours/week) Monday - Saturday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (8:00am - 8:00pm EST). It may be necessary, given the business need, to work occasional overtime. This is a challenging role with serious impact. You'll need strong analytical skills and the ability to effectively interact with other departments to obtain original claims processing details.  You'll also need to effectively draft correspondence that explains the claim resolution/outcome as well as next steps/actions for the member.   Training will be conducted virtually from your home. What we do defines who we are. Take a deeper look at how we're providing support during this global health crisis and search for a way you can get involved. View our Covid-19 Resources Page at: HTTPS://INFO.UHG.COM/ PRIMARY RESPONSIBILITIES:

• Research and resolve written complaints submitted by consumers and physicians/providers
• Ensure complaint has been categorized correctly
• Obtain additional documentation required for case review
• Review case to determine if review by clinician is required
• Render decision for non-clinical complaints using sound, fact-based decision making
• Complete necessary documentation of final appeals or grievance determination using appropriate templates
• Communicate appeal or grievance information to members or providers and internal/external parties within the required timeframes

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.REQUIRED QUALIFICATIONS:

• High school diploma or GED OR equivalent years of work experience
• 1+ year of experience analyzing and solving customer problems OR 1+ year of work experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
• Proficiency with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
• If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

PREFERRED QUALIFICATIONS:

• Experience with health care, medical, or pharmacy terminology

SOFT SKILLS:

• Strong written communication skills including advanced skills in grammar and spelling

UNITEDHEALTH GROUP IS AN ESSENTIAL BUSINESS. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non-clinical workforce transitioned to a work at home (remote) status.  We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.  Some of the steps we've taken to ensure employee well-being include:

• Transitioned our new hire training classes to be conducted virtually
• Launched our ProtectWell app and UnitedCARES program to help ease the burden and stress for our UnitedHealth Group team members and their immediate family affected by COVID-19
• Daily updates from our CEO Dave Wichmann to support and inspire team members during this challenging time
• Onsite social distancing and increased sanitization measures for employees who have been welcomed back to our offices
• Fully cover the COVID-19 healthcare costs for our employees 
• Employees who self-identify as high risk or who live with someone who is high risk have been asked to remain working from home

You can learn more about all we are doing to fight COVID-19 and support impacted communities at: https://www.unitedhealthgroup.com/newsroom/addressing-covid.html CAREERS WITH UNITEDHEALTHCARE. Let's talk about opportunity. Start with a Fortune 6 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: 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. Keywords:  Healthcare, health care, Managed Care, Appeals, Billing Representative, Billing, Collections, Claims, Customer Service, Medical Billing, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately