Requisition Number: 2362434 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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Work at home! The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies - Perform Department of Insurance/Department of Managed Healthcare, and CMS regulatory responses - Communicate with UnitedHealthcare medical directors regarding appeals decision rationales, and benefit interpretations - Communicate with UnitedHealthcare Regional and Plan medical directors and network management staff regarding access, availability, network, and quality issues - Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation, and the sharing of program results - Provide clinical and strategic input when participating in organizational committees, projects, and task forces What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - MD or DO with an active, unrestricted license - Board Certified in an ABMS or AOBMS specialty - 5+ years clinical practice experience - 2+ years of Quality Management experience - Intermediate or higher level of proficiency with managed care - Basic computer skills, typing, word processing, presentation, and spreadsheet applications skills. Internet researching skills - Proven excellent telephonic communication skills; excellent interpersonal communication skills - Proven excellent project management skills - Proven data analysis and interpretation skills - Proven excellent presentation skills for both clinical and non-clinical audiences. Familiarity with current medical issues and practices - Proven creative problem-solving skills - Proven solid team player and team building skills Compensation for this specialty generally ranges from $248,500 - $373,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Role Description As a Remote Insurance Reimbursement Specialist at Community Health Systems (CHS) - Shared Services Center, you’ll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. - Processes and verifies reimbursement claims, ensuring accuracy and compliance with payer guidelines and regulatory requirements. - Reviews and resolves claim discrepancies, identifying incorrect payments, denials, or underpayments and taking appropriate action. - Applies correct transaction codes to accounts, ensuring proper claim adjudication and reimbursement flow. - Monitors and follows up on outstanding claims, ensuring timely resolution and payment collection. - Collaborates with revenue cycle teams and payers to investigate claim denials and appeal decisions when necessary. - Researches and interprets payer policies, ensuring adherence to reimbursement requirements and claim submission rules. - Documents account actions accurately and thoroughly in the appropriate systems, maintaining compliance with department protocols. - Identifies process improvement opportunities, contributing to increased efficiency and streamlined reimbursement workflows. - Maintains strict confidentiality of patient and financial information, ensuring compliance with HIPAA and corporate policies. - Performs other duties as assigned. - Complies with all policies and standards. This is a fully remote opportunity. Qualifications - H.S. Diploma or GED required - Associate Degree or coursework in Accounting, Finance, Healthcare Administration, or related field preferred - 0-1 years of experience in medical billing, reimbursement, claims processing, or accounts receivable required - Experience with payer reimbursement policies, claim adjudication, and healthcare revenue cycle operations preferred Requirements - Strong knowledge of medical billing, reimbursement procedures, and payer guidelines. - Familiarity with claim submission, denial management, and appeals processes. - Ability to analyze account balances, identify discrepancies, and apply appropriate adjustments. - Proficiency in electronic health records (EHR), billing software, and reimbursement systems. - Strong problem-solving and critical-thinking skills, ensuring accurate claims resolution. - Effective communication and collaboration skills, working with payers, revenue cycle teams, and internal departments. - Knowledge of HIPAA, compliance regulations, and healthcare reimbursement standards. Benefits - Paid Time Off (PTO) - Comprehensive Health Benefits - Medical, Dental & Vision - 401k with company match - Tuition reimbursement

Role Description We are seeking a reliable and patient-focused Healthcare Virtual Assistant to support a growing medical practice with front desk operations, patient scheduling, insurance verification, billing support, and administrative tasks. The ideal candidate has experience working in a medical office environment, excels at patient communication, and can confidently manage phone calls, scheduling, insurance-related tasks, and administrative workflows while maintaining a high level of professionalism and accuracy. This is a long-term opportunity for someone who is dependable, detail-oriented, and committed to providing an exceptional patient experience. Core Responsibilities - Phone Support & Patient Communication (Top Priority) - Answer incoming patient phone calls professionally and efficiently - Manage patient callbacks and follow-up communications - Respond to patient inquiries and administrative requests - Provide excellent customer service and patient support through phone and electronic communication - Handle patient concerns with professionalism and empathy - Appointment Scheduling & Coordination (Top Priority) - Schedule, reschedule, and confirm patient appointments - Manage no-show appointments and rescheduling efforts - Support patient check-in and check-out workflows - Maintain accurate scheduling records within NexTech EHR - Insurance Verification & Claims - Verify patient insurance eligibility and benefits - Submit and follow up on prior authorizations - Coordinate with insurance companies regarding claims and authorizations - Assist with medical billing tasks and claims follow-up - Post patient payments accurately into the practice management system - Maintain organized billing and account records - Administrative Support - Update and maintain accurate patient records in NexTech EHR - Support front desk and administrative operations as needed - Assist with documentation and workflow management - Ensure HIPAA compliance and patient confidentiality at all times - Software & Systems - NexTech EHR (Primary System) Qualifications - Medical office, healthcare, nursing, or clinical experience required - Experience with patient scheduling and front desk operations preferred - Experience with insurance verification, prior authorizations, or billing support preferred - Experience using NexTech EHR strongly preferred - Previous virtual assistant experience is a plus Requirements - Excellent phone etiquette and verbal communication skills - Strong customer service and patient support skills - Knowledge of insurance verification and patient eligibility processes - Familiarity with medical billing and payment posting - Ability to multitask and manage competing priorities - Strong attention to detail and accuracy - Excellent organizational and time management skills - Ability to work independently while following established workflows - Strong problem-solving and critical-thinking abilities - Comfortable handling confidential patient information - Ability to learn new systems and adapt quickly Deal Breakers - No medical office, healthcare, or patient-facing experience - Poor English communication skills or weak phone presence - Lack of reliability, frequent absences, or unstable work history - Inability to multitask in a fast-paced medical office environment - Unwillingness or inability to learn NexTech EHR - Poor attention to detail when handling patient records, payments, or insurance information - Weak customer service skills or unprofessional communication - Failure to maintain HIPAA compliance and patient confidentiality - Unstable internet connection or unreliable remote work environment - Seeking only short-term employment - Poor responsiveness during the hiring process Basic Requirements - Must be proficient in speaking and writing English very clearly - Must have relevant work experience - Be able to submit an NBI clearance and/or Local Police Clearance background check before onboarding [mandatory] - Must be available for video meetings with your camera on (when needed) Technical Requirements - Device: Reliable laptop or desktop computer. - Internet: High-speed connection (minimum 25 Mbps). - Audio: Noise-canceling headset. - Video: Webcam for virtual meetings. - Workspace: Quiet, professional environment. Benefits - Dedicated HR & Contractor Support Team: Access to world-class support for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license can be provided upon request to enhance privacy and security for client-related tasks. - HIPAA & Cybersecurity Training + Certification (Provided): Access to our internal HIPAA compliance training, cybersecurity modules, and certification to help you confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Access to our proprietary training on communication, client management, productivity systems, and best practices to help you become a top-performing VA and increase long-term client retention. - Client-Approved U.S. Holidays: Contractors may take U.S. holidays off according to the client’s needs and schedule. - Client-Approved Paid or Unpaid Time Off: Time off may be granted by your client. Paid time off is optional and only if offered by the client. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support to help you perform at your best. - Optional Performance-Based Incentives: Some clients may offer bonuses, incentives, or increased hours based on your performance.

Role Description If you're driven, coachable, and ready to get paid based on your effort, this may be the opportunity you've been looking for. Meron Financial Agency is expanding in the Houston market and actively hiring agents who want to grow fast and earn at a high level. This is not a slow, hourly job. This is a performance-based career with real upside. - You will work with people who already requested information through inbound leads. - You will also have outbound opportunities/warm leads to increase your income faster. - You will follow a proven system with clear training and support. What You'll Be Doing: - Speak with clients over the phone or Zoom. - Help families choose life insurance coverage that fits their needs. - Work both warm inbound leads and Warm Lead leads - No Cold Calling. - Track activity and stay consistent with daily production. - Attend training and improve your sales skills. Qualifications - You want to earn more and are willing to work for it. - You are coachable and take direction well. - You are comfortable talking to people daily. - You are looking for growth, not just a job. Requirements - Must live in the U.S. with Houston preferred. - Must be a U.S. citizen or legal resident. - Able to pass a background check. - Life and Health License or willingness to obtain quickly. Benefits - 100 percent commission with uncapped earning potential. - Average earnings are $800 to $1,200 per sale. - Part-time agents earn $50K plus in their first year. - Full-time agents earn $80K to $300K plus. - Daily/Weekly pay. - Performance-based incentives. - Long-term income opportunities. - Leads with a mix of inbound and outbound opportunities. - Step-by-step training and mentorship. - Access to 60 plus insurance carriers. - Remote flexibility/In Office training. - Clear path to leadership and team building. Apply Now We are hiring a limited number of agents in this market. If you are serious about increasing your income and building something long term, apply today.