Appeals Clerk - Phoenix, AZ
Company: UnitedHealth Group
Location: Phoenix
Posted on: April 27, 2025
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Job Description:
At UnitedHealthcare, we're simplifying the health care
experience, creating healthier communities and removing barriers to
quality care. The work you do here impacts the lives of millions of
people for the better. Come build the health care system of
tomorrow, making it more responsive, affordable and equitable.
Ready to make a difference? Join us to start Caring. Connecting.
Growing together.
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 local time. It may be necessary, given the business need, to
work occasional overtime. Our office is located at 1 E Washington,
Ste 900, Phoenix AZ 85004.
We offer weeks of on-the-job training and the hours during training
will be 6am to 5pm, Monday - Friday.
Primary Responsibilities:
Research and resolve written complaints submitted by consumers and
physicians/providers
Ensure complaint has been categorized correctly
File, Sorting, Scanning and Data Entry of incoming mail
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
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 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
Ability to lift 10-15 pounds and stand for an extended period of
time (30min to an hour at different time increments throughout the
day)
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 local time. It may be necessary, given the business need, to
work occasional overtime
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. ,
click "My Profile", click "Organization Chart". Look upward on the
org chart to confirm that you report through Ops & Experience, and
Mike Baker)
Soft Skills:
Demonstrated 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
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.
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.
UnitedHealth Group is an Equal Employment Opportunity employer
under applicable law and qualified applicants will receive
consideration for employment without regard to race, national
origin, religion, age, color, sex, sexual orientation, gender
identity, disability, or protected veteran status, or any other
characteristic protected by local, state, or federal laws, rules,
or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are
required to pass a drug test before beginning employment.
#RPO #RED
Keywords: UnitedHealth Group, Sun City , Appeals Clerk - Phoenix, AZ, Other , Phoenix, Arizona
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