Job: Appeals Representative Senior - Cypress, CA

Jobing Description

Position Description:
Flexible? Friendly? Fast on your feet? That's a great start. Accurate? Accountable? Self Directed? These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and they way those services get paid. It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.

Primary Responsibilities:

• Provide expertise or general claims support by reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances.


• Analyze and identify trends and provides reports as necessary


• Consistently meet established productivity, schedule adherence, and quality standards


• Provide excellent customer service

UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:

UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.

UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.

UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.

Together, we're removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.

Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.

Skills / Requirements

Requirements:

• 
  
  High School Diploma or GED
  


• 
  
  Experience with Medicare Products, preferably Part D
  


• 
  
  1+ year of experience in a call center environment analyzing and solving customer problems OR 1+ year of experience using the telephone and computer as the primary instruments to perform job duties
  

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.