Job: Clinical Appeals Representative - Schaumburg, IL

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Jobing Description

Position Description:
Responsible for triage of mail received in appeal department. Enters case into appeal database and completes initial research on appeals

Positions in this function are responsible for providing expertise or general support to teams in reviewing, and researching all types of appeals and grievances. Communicates with appropriate parties regarding appeals and grievance issues. Some work is completed without established procedures. Basic tasks are completed without review by others. Supervision/guidance is required for higher level tasks.

OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

OptumHealth 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 health care 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 & Performance.

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.

Skills / Requirements

Requirements:

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  High school diploma or GED required.
  


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  2 or more years of experience in a customer service and/or clerical/administrative role within a call center required.
  


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  Knowledge of Microsoft Word and Outlook required.
  

Assets:

Healthcare Industry experience preferred.
Intake or Medical Claims experience a plus.
Appeals experience preferred.
Experience with Medicaid and/or Medicare a plus.
College Degree Preferred.

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

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.