Advantages of Joining Our Company:

- Opportunity to invent the future of health care
- Going beyond basic care to integrated health programs
- Contributing to helping people live healthier lives
- Remote work flexibility for California residents
- Clear direction and development opportunities for career growth

Job Responsibilities:

- Research and resolve written complaints from consumers and physicians/providers
- Categorize complaints accurately
- Obtain necessary documentation for case review
- Determine if clinician review is required
- Make non-clinical complaint decisions based on facts
- Complete documentation of appeals or grievance determinations
- Communicate appeal or grievance information to members, providers, and internal/external parties
- Utilize analytical skills to obtain original claims processing details
- Act as a subject matter expert on regulatory guidelines and privacy policies
- Draft correspondence explaining claim resolution and next steps for members
- Provide expertise and support in resolving appeals and grievances
- Communicate with appropriate parties regarding appeal and grievance issues
- Analyze and identify trends in appeals and grievances

Required Qualifications:

- High school education or equivalent experience
- 2+ years of healthcare experience with knowledge of medical claims and billing
- Proficiency with computer applications and ability to learn new systems
- Strong written communication skills
- Ability to multi-task and understand multiple products and benefits

Preferred Qualifications:

- 2+ years of experience in analyzing and solving appeals and grievances
- Experience in an office environment using telephone and computer for job duties

Additional Information:

- All employees working remotely must adhere to UnitedHealth Group's Telecommuter Policy
- Hourly range for California residents is $18.80 to $36.78, based on factors such as education and experience
- UnitedHealth Group offers comprehensive benefits, incentive and recognition programs, equity stock purchase, and 401k contribution
- Commitment to mitigating impact on the environment and delivering equitable care
- Equal Employment Opportunity/Affirmative Action employer
- Drug-free workplace, candidates must pass a drug test before employment begins