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Senior Clinical Appeals Reviewer - Atlanta, GA, Chicago, IL, Philadelphia, PA, or St. Louis, MO only

UnitedHealth Group

Atlanta, GA
Job Code:
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Job Details

Senior Clinical Appeals Reviewer - Atlanta, GA, Chicago, IL, Philadelphia, PA, or St. Louis, MO only(Job Number:729157)

Position Description:

Energize your career with one of Healthcare’s fastest growing companies.  


You dream of a great career with a great company - where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our Service Centers, improve our Service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.


This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.


Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their Healthcare needs, and stay on track with their Health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation, and Performance.

Employees 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 issues, implications, and decisions with appropriate parties. 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. (Positions responsible for Claims Appeals can be found in the Claims job family.)

Primary Responsibilities:

  • Extensive work experience, possibly in multiple functions. 
  • Work does not usually require established procedures.
  • Work independently.
  • Mentor others.
  • Act as a resource for others.
  • Coordinate others' activities.

***Position can be located in: Atlanta, GA, Chicago, IL, Philadelphia, PA, St. Louis, MO***

Job Clinical Appeals
Primary Location US-GA-Atlanta
Other Location US-PA-Philadelphia, US-MO-St. Louis, US-IL-Chicago
Organization Optum Ops-PHM Utilization Mgmt
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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