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Clinical Appeals Reviewer - Telecommute in California; Nevada; Oregon; Texas or Washington

UnitedHealth Group

Cypress, CA
Job Code:
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Job Details

753789 Clinical Appeals Reviewer Telecommute in California Nevada Oregon or Washington

Clinical Appeals Reviewer - Telecommute in California; Nevada; Oregon; Texas or Washington (753789)

Position Description

Position Description:
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.
Primary Responsibilities:
  • Pull medical cases from a queue
  • Research these medical cases and create write up summaries
  • Pass medical case write up summaries on to nurses
  • Receive decisions on whether a case is approved or denied
  • Relay information to the members and document your work
  • Other duties as assigned
Required Qualifications:
  • High School Diploma / GED
  • 1+ years of experience working with Insurance Clinical Appeals
  • Previous experience working with Microsoft Office including: Microsoft Outlook (ability to create, edit, save, and send documents), Microsoft Word (ability to create, edit, save, and send documents), and Microsoft Excel (ability to create, edit, save, and send spreadsheets)
  • Ability to navigate a PC to open applications, send emails, and conduct data entry
  • Must live in West Coast: California, Nevada, Oregon, Texas or Washington
Preferred Qualifications: 
  • Insurance Claims experience
  • Experience with E&I platform
  • Previous SCIIDRS, IDRS, ECAA, ETS, IQ, systems experience 
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.
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, Healthcare, UnitedHealth, Appeals, Insurance, California, Oregon, Washington, Nevada

Job Details

  • Contest Number753789
  • Job TitleClinical Appeals Reviewer - Telecommute in California; Nevada; Oregon; Texas or Washington
  • Job FamilyMedical and Clinical Operations
  • Business SegmentUHC Clinical Services

Job Location Information

  • Cypress, CA
    United States
    North America
  • Other LocationsPortland, OR
    Las Vegas, NV
    Chico, CA
    Tacoma, WA
    Reno, NV

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusNon-exempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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