Clinical Appeals RN - Cypress, CA or Telecommuter
Location: California
Description: UnitedHealth Group is looking of Clinical Appeals RN - Cypress, CA or Telecommuter right now, this job will be placed in California. For detail informations about this job opportunity kindly see the descriptions. If you're interested in bringing your nursing experience to a role that offers regular, Monday through Friday business hours and ample potential for advancement, ap! ply to join us as one of our newest nurses for our Appeals team! The chosen candidate will perform clinical reviews to ensure compliance with clinical standards, appeal/grievance procedures and coding practices, and to identify quality issues.
The position is responsible for reviews for the Medicare Provider appeals.
Your primary responsibilities would include:
Reviewing cases within a regulatory timeframe
Addressing urgent/emergency cases
Researching issues to mitigate risk
Working closely with a variety of internal departments
Communicating directly with members and physicians The chosen candidate must possess:
Current, unrestricted RN license in your state of residence
Minimum 1 year of clinical experience gained in an acute care or outpatient setting
MS Office and Internet proficiency
Strong organizational skills
Strong communication skills, written and verbal
Candidates who also have one or more ! of the following will be preferred:
Appeals experienc! e strongly preferred
CPT and/or ICD 9 experience is strongly preferred
Managed care experience is strongly preferred
Utilization review and/or case management experience is preferred
BSN
CCM
Previous experience in a telephonic role
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 are 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.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth 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.
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to UnitedHealth Group.
If you interested on this job just click on the Apply button, you will be redirected to the official website
This job starts available on: Sat, 23 Nov 2013 00:11:10 GMT
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