Senior Appeals Representative - Remote in AZ
Company: UnitedHealthcare
Location: Tempe
Posted on: May 12, 2025
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Job Description:
UnitedHealth Group is a health care and well-being company
that's dedicated to improving the health outcomes of millions
around the world. We are comprised of two distinct and
complementary businesses, UnitedHealthcare and Optum, working to
build a better health system for all. Here, your contributions
matter as they will help transform health care for years to come.
Make an impact with a diverse team that shares your passion for
helping others. Join us to start Caring. Connecting. Growing
together.
Let's talk about diplomacy. Let's talk about accuracy. Let's talk
about how UnitedHealth Group became a Fortune 10 company leader in
healthcare. We did it by working to become an undisputed leader in
creating service quality and helping to improve the lives of
millions. Now, here's where you come in. You can build on your
problem-solving skills by taking on responsibility for reviewing,
researching, investigating and triaging claims that were denied
determining their correct status. You'll drive the action and
communicate with appropriate parties regarding appeals and
grievance issues. In turn, we'll provide you with great training,
support and opportunities.
This position is full-time (40 hours/week) Monday - Friday.
Employees are required to have flexibility to work any of our
8-hour shift schedules during our normal business hours of (6:00am
- 5:00pm). It may be necessary, given the business need, to work
occasional overtime. Our office is located at Arizona.
This will be on the job training and the hours during training will
be 6am to 5pm, Monday - Friday.
If you are located in Arizona, you will have the flexibility to
work remotely* as you take on some tough challenges.
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Primary Responsibilities:
Research and resolve written complaints submitted by consumers and
physicians/providers
Ensure complaint has been categorized correctly
Obtain additional documentation required for case review
Review case to determine if review by clinician is required
Render decision for non-clinical complaints using sound, fact-based
decision making
Complete necessary documentation of final appeals or grievance
determination using appropriate templates
Communicate appeal or grievance information to members or providers
and internal/external parties within the required timeframes
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You'll be rewarded and recognized for your performance in an
environment that will challenge you and give you clear direction on
what it takes to succeed in your role as well as provide
development for other roles you may be interested in.Required
Qualifications:
High School Diploma / GED (or higher) OR equivalent work
experience
Must be 18 years of age or older
2+ years of experience analyzing and solving appeals and grievances
in an office environment using the telephone and computer as the
primary instruments to perform job duties OR 2+ years of experience
in a healthcare setting with knowledge of the medical -claims
and/or billing process
Proficiency with computer and Windows PC applications, which
includes the ability to navigate and learn new and complex computer
system applications
Ability to work full-time (40 hours/week) Monday - Friday.
Employees are required to have flexibility to work any of our
8-hour shift schedules during our normal business hours of (6:00am
- 5:00pm). It may be necessary, given the business need, to work
occasional overtime
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Preferred Qualifications:
Presently employed within UHC Operations & Experience. Those
currently employed outside that unit will not be considered. (To
verify, review - your Sparq profile and the organization chart.
Sparq Homepage, click "My Profile", click "Organization Chart".
Look upward on the org chart to - confirm that you report through
Ops & Experience, and Mike Baker)
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Telecommuting Requirements:
Reside within Arizona
Ability to keep all company sensitive documents secure (if
applicable)
Required to have a dedicated work area established that is
separated from other living areas and provides information
privacy
Must live in a location that can receive a UnitedHealth Group
approved high-speed internet connection or leverage an existing
high-speed internet service
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Soft Skills:
Strong written communication skills including advanced skills in
grammar and spelling
Ability to multi-task, this includes the ability to understand
multiple products and multiple levels of benefits within each
product
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*All employees working remotely will be required to adhere to
UnitedHealth Group's Telecommuter Policy
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The hourly range for this role is $19.86 to $38.85 per hour based
on full-time employment. Pay is based on several factors including
but not limited to local labor markets, education, work experience,
certifications, etc. UnitedHealth Group complies with all minimum
wage laws as applicable. In addition to your salary, UnitedHealth
Group offers benefits such as a comprehensive benefits package,
incentive and recognition programs, equity stock purchase and 401k
contribution (all benefits are subject to eligibility
requirements). No matter where or when you begin a career with
UnitedHealth Group, you'll find a far-reaching choice of benefits
and incentives.
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At UnitedHealth Group, our mission is to help people live healthier
lives and make the health system work better for everyone. We
believe everyone-of every race, gender, sexuality, age, location,
and income-deserves the opportunity to live their healthiest life.
Today, however, there are still far too many barriers to good
health which are disproportionately experienced by people of color,
historically marginalized groups, and those with lower incomes. We
are committed to mitigating our impact on the environment and
enabling and delivering equitable care that addresses health
disparities and improves health outcomes - an enterprise priority
reflected in our mission.
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Diversity creates a healthier atmosphere: UnitedHealth Group is an
Equal Employment Opportunity / Affirmative Action employer, and all
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, age, national origin,
protected veteran status, disability status, sexual orientation,
gender identity or expression, marital status, genetic information,
or any other characteristic protected by law.
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UnitedHealth Group is a drug - free workplace. Candidates are
required to pass a drug test before beginning employment.
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#RPO #RED
Keywords: UnitedHealthcare, Surprise , Senior Appeals Representative - Remote in AZ, Other , Tempe, Arizona
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