Job: Appeals Representative Associate - Cypress, CA

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Jobing Description

Primary Responsibilities:

• Review correspondence to determine classification of complaint type and sub-type.


• Determine if case requires creation of multiple complaint records.


• Determine if representative/appellant is authorized party.


• Determine if complaint is valid (filed within established guidelines).


• Forward documents for translation.


• Locate and interpret information from a number of databases.


• Enter data into workflow tool/database.


• Gather documents from various systems and add to image repository.


• Generate outbound correspondence using pre-approved templates.


• Initiate outbound phone calls as needed.


• Meet established productivity, schedule adherence, and quality standards.

UnitedHealthcare Employer & Individual 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.

When you work with UnitedHealthcare Employer & Individual, what you do matters. It's that simple...and it's that challenging.

In providing consumer-oriented health benefit plans to millions of people, our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system.

Regardless of your role at UnitedHealthcare Employer & Individual, the support you feel all around you will enable you to do what you do with energy, integrity, and confidence. So take the first step in what is sure to be a fast paced and highly diversified career.

Skills / Requirements

Requirements:

• High School Diploma/GED


• 1+ year of Customer Service Experience in a Call Center Environment Analyzing and Solving Customer Problems OR 1 year of Experience in a Corporate Environment


• 1+ year of Microsoft Word and Excel experience


• Ability to Work Overtime As Needed

Assets:

• Experience with Healthcare/Medicare Terminology

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.