Appeals Specialist - UnitedHealth Group : Job Details

Perform various appeal management duties from when the appeal is open until it is resolved and closed Reviewing, researching, investigating, negotiating and resolving appeals via live calls. Emails and spreadsheets Professionally resolve claim appeals in support of the pricing methodology used for each claim as determined by the client Complete necessary documentation throughout the appeal process using appropriate templates Communicate appeal or grievance information to members, providers, clients, client advocates and/or internal/external parties within the required timeframes Handling live calls from members, providers, clients, and client advocates efficiently and effectively using available business rules and guidelines set by our clients in determining the appropriate course of action Youll 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 f...Appeals Specialist, Appeals, Specialist, Microsoft, Health, Healthcare, Skills