Clinical Appeals RN - Remote in US

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based claims.

Review provider post-service appeals for Medicare and Retirement Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines Discuss cases with medical directors when applicable Ability to communicate and collaborate with other teams in order to gather medical information to process cases Communicate effectively in both verbal and written documentation Must meet quality and productivity metrics Ability to work independently and prioritize Attend mandatory trainings and scheduled staff meetings Engage in respectful and courteous team dialog via email, IM and in staff meeting