Grievances Coordinator - Cypress, CA
Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances. Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions. Analyzes and identifies trends for all appeals and grievances. May research and resolve written Department of Insurance complaints and complex or multi-issue provider complaints submitted by consumers and physicians/providers.
- An education level of at least a high school diploma or GED
- 2+ years of experience analyzing and solving medical appeals and grievances in an office setting environment using the telephone and computer as the primary instruments to perform job duties
- Proficiency with computers and Windows PC applications (MS Word, Excel, and Email), which includes the ability to learn new and complex computer system applications
- Must be able to work overtime as business needs require
- Medicare experience preferred
- Experience with Healthcare/Medical terminology preferred
- Prior stable work experience
- Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
- Ability to remain focused and productive each day though tasks may be repetitive
- Authorization to work in the United States
- Available to work 40 hours per week within the operating hours of the site
Physical Requirements and Work Environment:
- Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
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.
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.