Research Analyst (Medicare appeals for a healthcare leader!)

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.



PacifiCare Health Systems is now part of UnitedHealthcare, a UnitedHealth Group company. As one of the nation’s leading consumer health organizations, we are recognized by over 3 million health plan members for delivering first-to-market innovations as well as affordable high-quality programs. And, as part of UnitedHealthcare, we can offer you that rare combination of building a rewarding career with a healthy business while improving the lives of others.


 


Due to promotion, we have an opening for a research expert to deal with final appeals in Medicare claims cases. The position is fast-paced and challenging, with a variety of interesting cases, and offers growth potential within a Fortune 100 Company. The Research Analyst will be researching appealed cases, and presenting his/her findings to a committee. Depending on the decisions of the committee, the analyst may then present the case in court before an Administrative Law Judge.


 


Key responsibilities include:



Researching appealed case histories, in light of Medicare regulations, to evaluate the company’s claims decisions


Presenting cases and arguing for specific outcomes at a bi-weekly meeting with a Vice President and committee members


Arguing some cases before an Administrative Law Judge


Overturning prior decisions in other cases



Research and regulatory experience are required for this position, as are strong organizational, writing and presentation skills. Computer proficiency is also necessary. A background in insurance and/or healthcare is preferred, and knowledge of authorization databases and online research tools is a plus. Paralegals are encouraged to apply. If you meet these criteria, and you are a team-oriented and persuasive individual, we invite you to apply for this uncommon position.


 


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:  paralegal, research, analysis, legal research, appeals coordinator, regulatory affairs, government relations, Medicare, appeals, healthcare, insurance