Clinical Appeals Reviewer - National Remote Job at UnitedHealth Group, Phoenix, AZ

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  • UnitedHealth Group
  • Phoenix, AZ

Job Description

**Optum** is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together** This position is full time (40 hours / week), Sunday - Saturday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 AM - 5:00 PM PST. It may be necessary, given the business need, to work occasional overtime and weekends. Specific schedule will be assigned either one week before the employment or on the first day of employment. We offer 4 - 6 weeks of paid training. The hours of the training will be aligned with your schedule. or will be discussed on your first day of employment. **Training will be conducted virtually from your home.** You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Manage administrative intake of members + Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and / or providers + Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles + Handle resolution / inquiries from members and / or providers + Other duties as assigned This is a Provider/customer service environment. You'll need to be efficient, productive and thorough dealing with our providers/ members over the phone. You also must be able to work a flexible schedule that includes evening hours. 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 equivalent years of experience + Must be 18 years of age OR older + 2+ years of customer service experience + Experience with working in the healthcare industry OR in a hospital, physician's office, medical clinic, OR medical insurance setting + Experience with Windows based programs including Microsoft Word, Microsoft Excel, and Microsoft Outlook + Ability to work any of our full time (40 hours / week), 8-hour shift schedules during our normal business hours of 8:00 AM - 5:00 PM PST from Sunday - Saturday including the flexibility to work occasional overtime and weekends based on business need. Specific schedule will be assigned either one week before the employment or on the first day of employment. **Preferred Qualifications:** + Clerical OR administrative support background + Knowledge of ICD - 10 and CPT codes + Experience with working in a call center **Telecommuting Requirements:** + Ability to keep all company sensitive documents secure (if applicable) + Required to have a dedicated work area established that is separated from other living areas and provides information privacy. + Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. **Soft Skills:** + Ability to multitask *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. **_Application Deadline: T_** _his will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants._ _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._ \#RPO

Job Tags

Hourly pay, Minimum wage, Full time, Work experience placement, Local area, Remote job, Flexible hours, Shift work, Sunday, Saturday, Afternoon shift,

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