Appeals Coordinator (Great entry into complaince!)

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.



United Behavioral Health, a UnitedHealth Group company, is a leading provider of emotional wellness services. Currently serving over 22 million Americans, our innovative solutions include behavioral health, employee assistance, work/life and pharmacy management services, as well as a unique disability support program. We offer specialized, confidential support to help our members live and work well, and excellent resources and rewards for your career so you can do the same. A healthy business awaits you at UBH.


 


Recent expansion of our business has created a new opening in our compliance department. This position combines the satisfaction of helping members in need of care with an excellent learning and growth opportunity within a Fortune 100 Company. The Appeals Coordinator will receive and track claim denial appeals while maintaining compliance with various accreditation agencies. He/she will also be responsible for some research on the issues surrounding these appeals.


 


Key responsibilities include:



Receiving healthcare appeals from members who have had claims denied


Logging the appeals, tracking their progress, and monitoring turnaround time


Completing required paperwork for accreditation compliance

Researching benefits and collaborating with the care advocacy department during the grievance process



This job requires healthcare experience, and claims experience in particular, as well as computer proficiency. We prefer candidates with HMO, MBHO and/or general health insurance backgrounds, and we also favor applicants with strong communication and organizational skills. If you meet these requirements, and you are also able to meet deadlines and work effectively on a team, this could prove an excellent opportunity to move into a career in compliance or account management.


 


UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.


 


If you are interested in growing professionally within an innovative, highly respected organization, we invite you to explore this excellent growth opportunity!


 


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


 


Keywords:  healthcare, insurance, claims, appeals, HMO, MBHO, customer service, LINX, CMM, RIOS, UNNET, FACETS, URAC, ERISA, NCQA, CSR, claims reviewer