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Clinical Appeals Reviewer - West Coast - Telecommute

UnitedHealth Group

Los Angeles, CA
Job Code:
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Job Details

Clinical Appeals Reviewer - West Coast - Telecommute(Job Number:725564)

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.


Positions in this function are responsible for providing expertise or general support in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances. Communicates with appropriate parties issues, implications and decisions. Analyzes and identifies trends for appeals and grievances.This includes senior level positions with education / certification / licensure other than an RN, such as BSW, MSW, DDS, Chiropractor, Physical Therapist, etc.


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 

Job Clinical Appeals
Primary Location US-CA-Los Angeles
Other Location US-WA-Seattle, US-OR-Portland, US-CA-San Francisco
Organization Clinical Appeals & Grievances
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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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