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.Primary Responsibilities: Provide expertise or general claims support by reviewing, researching, investigating, negotiating and resolving all types of appeals and grievancesAnalyze and identify trends and provides reports as necessaryConsistently meet established productivity, schedule adherence, and quality standardsProvide excellent customer serviceExtensive work experience within own functionWork is frequently completed without established proceduresWorks independentlyMay act as a resource for othersMay coordinate others activities
Required Qualifications:High School Diploma / GED or higher2+ years medical claims experience2+ 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 dutiesAbility to learn new and complex computer system applicationsPrior experience with COSMOS and / or NICEPreferred Qualifications:Experience with post service appealsPhysical Requirements and Work Environment:Extended periods of sitting at a computer and use of hands / fingers across keyboard or mouseCareers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in healthcare. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our Healthcare system. Ready? It's time to do your life's best work.SMDiversity 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: claims, medical claims, healthcare claims, claims processing, claims processor; office, UnitedHealth Group, UnitedHealthcare, training class, customer service representative, customer service, CSR, Data Entry, appeals, dispute resolution, phone support, San Antonio, TX; Dublin, OH
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.