Appeals Representative Associate, UnitedHealth Group

Primary Responsibilities:

• Research written complaints and complex or multi-issue provider complaints submitted by consumers and physicians/providers.
• Communicate with appropriate parties regarding appeals and grievance issues, implications and decisions.
• Analyze and identify trends for appeals and grievances.
• Apply knowledge/skills to basic, repeated activities.
• Respond to standard requests and solve routine problems by following established procedures.
• Work with others as part of a team and have work reviewed by others.

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 / GED (or higher)
• 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
• Beginner level of experience with Microsoft Word (create, edit, format documents) and Microsoft Excel (create, edit, format spreadsheets)

Preferred Qualifications:

• Experience with Healthcare/Medicare Terminology
• Managed Care and previous Appeals/Grievances experience

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to keep all company sensitive documents secure (if applicable)
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

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