Medical Claims & Appeals Reviewer (Flexible schedule)

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

At Uniprise, a UnitedHealth Group company, our people and technology meet the benefits needs of employees and families at more than one-fourth of the Fortune 500 companies through customization and innovation. National employers can then best access the full range of products and services offered by UnitedHealth Group companies while enjoying the ease of integrated administration for all employee services. It's a thriving business with an added personal significance-and a rare combination that will allow your career to flourish.



Due to rapid departmental growth, we need to hire a number of RNs to act as Medical Claims & Appeals Reviewers. This job features a flexible schedule and the possibility of working from home, along with growth potential in a Fortune 100 healthcare company. The position entails reviewing appeals on rejected claims. Some will be overturned, others will remain denied.



Key responsibilities include:


Identifying issues of dispute within rejected claims


Determining whether problems can be resolved


Referring unresolvable disputes to the Medical Field Director


Reporting results of appeals to other departments
Providing clinical expertise in the application of claims adjudication policies

Job Requirements:

You must be a licensed RN to be considered for this position with significant clinical experience. Basic computer proficiency is also required. A BSN degree is preferred, as is experience with medical terminology, medical claims review and utilization review. If you meet these criteria, and you have good communication and multitasking skills, you could be a great fit for this promising position.



UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.



If you are interested in growing professionally within an innovative, highly respected organization, we invite you to explore this excellent growth opportunity!



Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.



healthcare, insurance, RN, nurse, medical reimbursement, CPT, ICD-9, managed care, pre-certification