Senior Appeals Representative (SME) - Any UHG Office

United Health Group
Oct 13, 2016
Oct 19, 2016
Employer Type
Direct Employer
Employment Type
Full Time
Position Description:

Welcome to one of thetoughest and most fulfilling ways to help people, including yourself. We offerthe latest tools, most intensive training program in the industry and nearlylimitless opportunities for advancement. Join us and start doing your life'sbest work.(sm)

Positions in this functionare responsible for providing expertise or general support to teams inreviewing, researching, investigating, negotiating and resolving all types ofappeals and grievances. Communicates with appropriate parties regarding appealsand grievance issues, implications and decisions. Analyzes and identifiestrends for all appeals and grievances. May research and resolve internal and external complaints and complex ormulti-issue provider complaints submitted by consumers andphysicians/providers. Employees in jobs labeled with SCA must support a governmentService Contract Act (SCA) agreement.

Primary Responsibilities:

* Provide expertise or general claimssupport by reviewing, researching, investigating, negotiating and resolving alltypes of appeals and grievances.
* Analyze and identify trends and provides reports as necessary
* Consistently meet established productivity, schedule adherence, and qualitystandards
* Provide excellent customer service
* Extensive work experience within own function.
* Work is frequently completed without established procedures.
* Works independently.
* May act as a resource for others.
* May coordinate others' activities.


* High school diploma/GED
* 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
* Moderate proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications

Physical Requirements and Work Environment:

* Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse

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.

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