Appeals Service Representative - Cypress, CA

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.



Ovations, a UnitedHealth Group company, is dedicated to improving the health and well being of Americans over 50. We currently serve over 3.6 million individuals across the nation, helping to address their unique needs for preventive and acute health care services, deal with chronic conditions, and access to care and services. Come to Ovations and discover the rare combination of a rewarding career and the opportunity to make a difference in people's lives.


 


Job Responsibilities:


To work with the Health Plan Grievance Coordinator in the performance of administrative tasks related to processing and handling of member and provider complaints and grievances and clinical and administrative appeals.

Assist Grievance Coordinator in processing and resolution of complaints, grievances and appeals, following designated procedures.

Draft correspondence related to complaints, grievances and appeals.

Maintain documentation and logs of complaints, grievances and appeals.

Perform other related activities.


 




Job Qualifications:


High school education.

Ability to write coherent and clear correspondence and to relate with members and providers orally, well organized, ability to track and monitor receipt and resolution of grievances and appeals.

Experience with health care or government programs preferred.


Diversity creates a healthier atmosphere:  equal opportunity employer M/F/D/V.