Clinical Appeals RN - Remote Opportunity in EST Time Zone
Join UnitedHealthcare in transforming the healthcare experience, creating healthier communities, and breaking down barriers to quality care. As a Clinical Appeals RN, you will play a vital role in making a positive impact on the lives of millions. Enjoy the flexibility of working remotely from anywhere within the Eastern Standard time zone, with a standard Monday-Friday schedule from 8am-5pm EST.
In this role, you will:
Conduct initial assessments of appeals, medical records, and CMS/State Policies to determine coverage and billable criteria
Identify the need for additional information to process appeals
Utilize clinical nursing judgment and critical thinking skills to make informed decisions on administrative nurse-level cases
Navigate multiple computer programs, managing multiple tasks and priorities
Adapt to changes and cross-train on various appeal types as needed
In return for your expertise, you will be rewarded with a competitive salary, comprehensive benefits package, and opportunities for professional growth and development. If you are a motivated and experienced RN looking to make a difference, we encourage you to apply.
Required Qualifications:
Current, valid, and unrestricted RN licensure in your state of residence
2+ years of clinical experience in an acute care or outpatient setting
1+ year of direct experience in Utilization Review, Medicaid and/or Medicare appeals, or LOC assessment planning and Discharge SNF Planning
Proven understanding of billable services and claims in a managed care environment
Solid Microsoft Office skills and basic computer proficiency
Access to high-speed internet and ability to work 8am-5pm EST
Preferred Qualifications:
Solid coding experience or Certified Coder (CPC) certification
5+ years of Medical Appeal experience working with Medicare and Medicaid
UnitedHealth Group offers a competitive hourly range of $28.03 to $54.95 per hour, depending on location, experience, and qualifications. Our comprehensive benefits package includes incentives, recognition programs, equity stock purchase, and 401k contribution. We are an Equal Employment Opportunity/Affirmative Action employer, committed to diversity and inclusion in the workplace.
To apply, please submit your application through our website. We look forward to hearing from you!
Apply Now
Apply Now
In this role, you will:
Conduct initial assessments of appeals, medical records, and CMS/State Policies to determine coverage and billable criteria
Identify the need for additional information to process appeals
Utilize clinical nursing judgment and critical thinking skills to make informed decisions on administrative nurse-level cases
Navigate multiple computer programs, managing multiple tasks and priorities
Adapt to changes and cross-train on various appeal types as needed
In return for your expertise, you will be rewarded with a competitive salary, comprehensive benefits package, and opportunities for professional growth and development. If you are a motivated and experienced RN looking to make a difference, we encourage you to apply.
Required Qualifications:
Current, valid, and unrestricted RN licensure in your state of residence
2+ years of clinical experience in an acute care or outpatient setting
1+ year of direct experience in Utilization Review, Medicaid and/or Medicare appeals, or LOC assessment planning and Discharge SNF Planning
Proven understanding of billable services and claims in a managed care environment
Solid Microsoft Office skills and basic computer proficiency
Access to high-speed internet and ability to work 8am-5pm EST
Preferred Qualifications:
Solid coding experience or Certified Coder (CPC) certification
5+ years of Medical Appeal experience working with Medicare and Medicaid
UnitedHealth Group offers a competitive hourly range of $28.03 to $54.95 per hour, depending on location, experience, and qualifications. Our comprehensive benefits package includes incentives, recognition programs, equity stock purchase, and 401k contribution. We are an Equal Employment Opportunity/Affirmative Action employer, committed to diversity and inclusion in the workplace.
To apply, please submit your application through our website. We look forward to hearing from you!
Apply Now
Apply Now