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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Claims

Country:

United States

Postal Code:

98101

Approximate Salary:

Not Specified

Position Type:

Full Time

Senior Appeals Representative - Seattle, WA Telecommute

UHG - Seattle, Washington

Posted: 10/12/2018

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.

Primary Responsibilities:

  • Provide expertise or general claims support by reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances
  • Analyze and identify trends and provides reports as necessary
  • Consistently meet established productivity, schedule adherence, and quality standards
  • Provide excellent customer service
  • Responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances
  • Communicate with appropriate parties regarding appeals and grievance issues, implications and decisions
  • Analyze and identify 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
  • Extensive work experience within own function
  • Work is frequently completed without established procedures
  • Work independently
  • May act as a resource for others
  • May coordinate others activities

Required Qualifications:
  • High School Diploma / GED (or higher)
  • Medicaid experience
  • Intermediate proficiency with Microsoft Excel (data entry, filter)
  • Advanced proficiency with Microsoft Word (working within templates, creating documents)
  • Must be within commutable distance to Seattle, WA site
Preferred Qualifications:
  • Associate's Degree (or higher)
  • 2+ years of experience analyzing and solving appeals and grievances in an office setting environment using the telephone and computer as the primary instruments to perform job duties
Soft Skills:
  • Good phone skills- ability to professionally handle upset beneficiary calls
Physical Requirements and Work Environment:
  • Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV / AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do 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.


Keywords: UHG, Seattle, WA, appeals, grievances, Medicaid, UHC WA 2018

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