| Job ID | 213733 |
|---|---|
| Company Name | UnitedHealth Group |
| Job Category | Legal; Healthcare |
| Location | Memphis, TN |
| Position Type | Full-Time, Employee |
| Experience | Unspecified |
| Date Posted |
Job Description
Description
AmeriChoice, a UnitedHealth Group company, is a recognized leader and innovator in providing managed health care solutions to its membership, which includes Medicaid, Medicare and SCHIP recipients. With over a decade of growth and success, we are poised for continued expansion of our services in this dynamic marketplace. Our commitment to this specialized market makes a genuine difference in the lives of our 1.8 million members. Join us, do rewarding work, and build a great career.
We are currently seeking an experienced RN/LPN to take on the promising role of Appeals Review Nurse in our Memphis office. Primary responsibilities include:
- Reviewing medical records and looking to see if the requested service meets criteria
- Loading approvals into the system
- Assisting with response letters
- Coordinating reviews with the Medical Director
- Contacting providers to obtain medical records
Qualifications
The requirements for this role are as follows:
- An RN or LPN with a current and unrestricted license in the state of TN
- Excellent communication skills
- Solid computer proficiency
Additional assets include:
- Knowledge of a Medicaid/TennCare
- Experience with claims/billing
- Familiarity with medical codes
- Knowledge of Facets, Macess, CareOne and/or CarePlanner
When you become part of AmeriChoice, you also become part of something larger—a Fortune 100 leader with a broad spectrum of services and products—while still working for a company where you can see and feel your impact. It's the best of both worlds. If this is not the right opportunity for you at this time, please share it with the people you know who could excel in this role, and keep looking for the right opportunity for yourself at UnitedHealth Group.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
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