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Job Overview

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Energize your career with one of Healthcare’s fastest-growing companies.  

You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this. 

And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels, and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals.

No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

The Denials and Appeals Coordinator is directly responsible to the Manager of Appeals / Denials, or managerial designee, for the administrative and support tasks involved in the contracts between OrthoNet and Managed Care Payers regarding Utilization Management.  

Working with the OrthoCare Manager and/or Contract Assistant, the Denial Coordinator will be responsible for assuring the timely completion of all denial files for the various payor plans.

As non–clinical staff members, Denial Coordinators do not perform UM activities that require the interpretation of clinical information. Licensed health professionals are available for oversight and follow-up for clinical-related questions or issues.

This position is part-time. You can live in any time zone in the United States. Flexibility on remaining shifts, as long as you work at least 2 additional afternoon / early evenings between Monday and Friday.

Employees are required to work any shift (20 hours/week) between the hours of 9:00 AM – 5:30 PM EST (Eastern Standard Time zone) including the flexibility to work weekends (every Saturday) based on business needs. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Post Name Part – Time Denials and Appeals Coordinator – National Remote
Company Name UnitedHealth
Industry Private 
Work Remotely Yes

Primary Responsibilities:

  • Receiving and interpreting electronic appeal requests and decisions from our clients
  • Preparing electronic files for our clients as requested
  • Verifying information, calling and faxing to provider offices, entering data into letter templates, filing letters
  • Work with other team members to ensure work is going out timely and/or if follow-up is needed
  • Entering and maintaining information onto OrthoNet’s various databases
  • Participation in training classes regarding HIPPA, Confidentiality, URAC, Regulatory Compliance, Conflict of Interest, and department-specific training as applicable
  • All other duties as required, including possible Denial / Appeal Coordinator cross training

This is high volume, customer service environment. You’ll need to be efficient, productive, and detail-oriented. You also must be able to work a flexible schedule that includes evening hours.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you a 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)
  • 6+ months of experience in Data Entry
  • 6+ months of experience with working in a customer service environment, including communication via email and / OR phone
  • 6+ months of experience with Utilization Management processes
  • General knowledge of healthcare
  • Proficiency in operating computers applications
  • Experience with Microsoft Word (data entry, transcription, and working in existing templates), Microsoft Excel (data entry into existing templates), and Microsoft Outlook (create, send, and save email)
  • Availability to work any shift (20 hours/week) between the hours of 9:00 AM – 5:30 PM EST (Eastern Standard Time zone) including the flexibility to work weekends (every Saturday) based on business needs

Preferred Qualifications:

  • Administrative / Medical office experience
  • Knowledge of NCQA and state / federal standards and guidelines

Telecommuting Requirements:

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company-sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group-approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

  • Pleasant, professional demeanor, articulate customer service individual
  • Interpersonal and communication skills
  • Excellent interpersonal skills
  • Excellent verbal and written communications skills

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience are different and we like that. UnitedHealth Group values the skills, experience, and dedication that serving in the military demands.

In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation, and Performance.

Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; to make the health system work better for everyone.

So when it comes to how we use the world’s large accumulation of health-related information, guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve.

Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential.

For you, that means working on high-performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company, and a singular opportunity to do your life’s best work. SM

Colorado, Connecticut, or Nevada Residents Only: The salary range for Colorado residents is $16.00 – $26.88. The salary range for Connecticut / Nevada residents is $16.83 – $29.66.

Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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

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.

UnitedHealth Group is a drug–free workplace. Candidates are required to pass a drug test before beginning employment.

Schedule Type: Part Time 

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