and equitable. Ready to make a difference? Join us and start doing your life’s best work. SM Flexible? Friendly? Fast on your feet? That's a great start. Accurate? Accountable? Self Directed? These traits can take you places. Our claims operations are the focal point of handling information about services patients receive and the way those services get paid.
It's complex, detailed work. It's fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment. The Workers’ Compensation Claims Adjuster (Lost Time) reviews, analyzes, investigates, makes liability decisions and approves the release
of benefit payments up to authorized levels on initial, continued and reopened claims. This position is full-time. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm PST.
It may be necessary, given the business need, to work occasional overtime. Our office is located at 4828 S. Pearl Street, Las Vegas, NV 89121. We offer weeks of paid training. The hours during training will be 8:00am to 5:00pm PST, Monday - Friday. Primary Responsibilities: Evaluates new and on-going claims to determine liability, giving consideration to contract provisions, disability management duration contract guidelines, medical
evidence and vocational evidence. Investigates questionable claims.
Determines need for additional medical information. Performs periodic follow-ups to verify continued existence of a disabling condition. Responds to telephone and written inquiries from claimants, attorneys, physicians and policyholders. Identifies and forwards claims to specialized internal and external resources in areas such as rehabilitation, investigations, medical exams, settlements and Social Security. Keeps track of time frames required of mandated correspondence. This level is responsible for independently reviewing simple to moderately complex claims for adjudication purposes.
Refers more complex claims to higher levels. What are the reasons to consider working for United Health Group? Put it all together - a highly competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: 18 days of Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement - up to $5,250 per calendar year for job-related coursework Adoption Assistance Plan Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.
) · More information can be downloaded at: http: //uhg. hr/uhgbenefits 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: High School Diploma / GED 1+ years of experience adjudicating and processing Workers’ Compensation Lost Time claims OR 1+ years of experience working with complex or catastrophic claims within healthcare Current Nevada Staff Adjuster’s or Independent Adjuster License OR previous NV Staff Adjuster's or Independent Adjuster license (within the last 90 days) Experience with Microsoft Excel (data entry, sorting/filtering), Word (creating documents, templates, lists), and Outlook (send/receive email, create tasks, update calendar, set out of office) Ability to work onsite at 4828 S.
Pearl Street, Las Vegas, NV 89121 Ability to work full-time between 8:00am – 5:00pm PST including the flexibility to work occasional overtime given the business need Must be 18 years of age OR older Soft Skills: Advanced knowledge of fundamental concepts, practices and procedures of case law and state Worker’s Compensation laws, subrogation, reserve setting, and litigation management Ability to multi-task and understand multiple products and multiple levels of benefits within each product Excellent oral and written communication skills required Excellent analytical and problem-solving skills required Nevada Residents Only: The annual range for Nevada residents is $46,700 - $91,300 per year.
Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, United Health Group offers 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 United Health Group, you’ll find a far-reaching choice of benefits and incentives.
PLEASE NOTE The sign on bonus is only available to external candidates. Candidates who are currently working for a United Health Group, United Healthcare or related entity in a full time, part time, or per diem basis (" Internal Candidates" ) are not eligible to receive a sign on bonus. At United Health 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, interactionuality, 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. Diversity creates a healthier atmosphere: United Health Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, interaction, age, national origin, protected veteran status, disability status, interactionual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
United Health Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #REDFor more details: jobs-search. org/legal_las-vegas-c438598/workers-compensation-claims-adjuster-lost-time-las-vegas-nv-las-vegas_i1974660730
Join us and start doing your life’s best work. SM This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime.
Our office is located at 2720 N Tenaya Way Las Vegas, NV. We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule. Primary Responsibilities: Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating, and resolving all types of appeals
and grievances. Communicates with appropriate parties regarding appeals and grievance issues, implications, and decisions. Analyzes and identifies trends for all appeals and grievances.
May research and resolve written Department of Insurance complaints and complex or multi-issue provider complaints submitted by consumers and physicians/providers. Research Information Related to Claims Appeals or Grievances Analyze/research/understand how a claim was processed and why it was denied Obtain relevant medical records to submit appeals or grievance for additional review, as needed Leverage appropriate resources to obtain all information relevant to the claim Identify and obtain additional
information needed to make an appropriate determination Obtain/identify contract language and processes/procedures relevant to the appeal or grievance Work with applicable business partners to obtain additional information relevant to the claim (e.
g. Network Management, Claim Operations, Enrollment, Subrogation) Determine whether additional appeal or grievance reviews are required (e. g. medical necessity), and whether additional appeal rights are applicable Determine where specific appeals or grievances should be reviewed/handled, and route to other departments as appropriate CAP Process Claims Appeals or Grievances Identify and obtain additional information needed to make an appropriate determination Ensure that members obtain a full and fair review of their appeal or grievance Utilize appropriate claims processing systems to ensure that the claim is processed appropriate Make appropriate determinations about whether a claim should be approved or denied based on available analyses/research of claims information Document final determination of appeals or grievances using appropriate templates, communication processes, etc.
(e. g. response letters, Customer Service documentation) Communicate appeal or grievance information to appellants (e. g. members, providers) within the required timeframe (e.
g. DOL, DOI) Communicate appeal or grievance issues/outcomes to all appropriate internal or external parties (e. g. providers, regulatory This is a challenging role with serious impact. You’ll need strong analytical skills and the ability to effectively interact with other departments to obtain original claims processing details. You’ll also need to effectively draft correspondence that explains the claim resolution/outcome as well as next steps/actions for the member. 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: High School Diploma / GED OR equivalent years of work experience 2+ years of experience analyzing and solving appeals in the health care industry Experience with Microsoft Office including Microsoft Word (create correspondence and work within templates) Microsoft Excel (ability to sort and filter) Microsoft Outlook (email and calendar management) Ability to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm).
It may be necessary, given the business need, to work occasional overtime. Must be 18 years of age or older Preferred Qualifications: Experience utilizing claims platform FACETS Previous experience with creating resolution letters Experience with health care, medical, or shop terminology experience Experience in healthcare coding practices (e. g. CPT's, HCPCS, DRG, ICD-9, ICD-10) Experience with healthcare business segments (e. g. Commercial, Behavioral Health) Soft Skills: Research and analytical skills Strong written communication skills including advanced skills in grammar and spelling Nevada Residents Only: The hourly range for Nevada residents is $16.00 - $31.44 per hour.
Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, United Health Group offers 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 United Health Group, you’ll find a far-reaching choice of benefits and incentives.
At United Health 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, interactionuality, 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.
Diversity creates a healthier atmosphere: United Health Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, interaction, age, national origin, protected veteran status, disability status, interactionual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. United Health Group is a drug-free workplace.
Candidates are required to pass a drug test before beginning employment. #RPO #REDFor more details: jobs-search. org/onsite_las-vegas-c438598/onsite-appeals-representative-las-vegas-nv-las-vegas_i1973365938
strong legal research and writing skills, and have a proven track record in trial advocacy. The firm offers a competitive salary, health insurance, dental and vision plans, and unique opportunities for pro bono work. Duties: Demonstrate expertise in handling complex federal litigation cases.
Conduct extensive legal research and craft persuasive briefs and motions. Meticulously prepare for trials and/or oral arguments. Effectively manage multiple federal litigation cases concurrently. Ensure timely execution of case development. Requirements: J. D. degree from a School of Law accredited by the American Bar Association. Active member in good standing of the Bar of NV, territory of the United
States, the District of Columbia, or the Commonwealth of Puerto Rico. Minimum of 5 years of post-J. D. Experience relevant to litigation in federal courts.
Experience in trial advocacy, legal research, and writing. Strong understanding of federal laws and regulations. Familiarity with federal procedure and courtroom protocol. Excellent analytical, research, and communication skills. Persuasiveness and reasoned judgment. Complex case management skills. Experience in immigration/appellate law is highly desired. Education: J. D. degree from a School of Law accredited by the American Bar Association. Certifications: Must be an active member in good standing of the Bar of NV, territory of
the United States, the District of Columbia, or the Commonwealth of Puerto Rico.
Skills: Trial advocacy, legal research, and writing. Understanding of federal laws and regulations. Knowledge of federal procedure and courtroom protocol. Analytical, research, and communication skills. Persuasiveness and reasoned judgment. Complex case management. Job Location: Las Vegas, NV
proficiency in legal drafting and analysis. This role requires a detail-oriented individual with 2-4 years of civil litigation and/or transactional experience, licensed to practice in the State of Nevada. Job Details: Communicate effectively and appropriately with team members and outside parties.
Draft, review, and file legal pleadings, motions, discovery, etc. Review case files and pleadings to determine appropriate action. Work collaboratively as part of a team with individuals at all experience levels. Routinely communicate with clients to provide updates and gather information. Cultivate relationships with the firm's existing and future clients. Ensure compliance with all firm standard
operating procedures. Perform other duties as assigned to contribute to the firm's overall success. Requirements: Graduate of an accredited institution by the American Bar Association with a Juris Doctor degree and a specialization in law.
Licensed to practice in the State of Nevada and good standing with the Nevada State Bar.2-4 years of civil litigation and/or transactional experience, preferred. Working knowledge of civil procedures. Excellent legal drafting, writing, and verbal communication skills. Excellent interpersonal, analytical, and critical thinking skills. Ability to be detail-oriented, diligent, and flexible. Strong organizational and time management skills. Commitment to
continuous learning and professional development. Proficient in Microsoft Office Suite, including Word, Excel, and Outlook.
Ability to think and act independently, with minimal supervision. Committed to maintaining integrity and confidentiality on behalf of clients and the Firm. Professional appearance and demeanor. Job Location: Las Vegas, NVBenefits offered: The firm offers a comprehensive benefits package, including: Paid time off Paid holidays Medical, dental, vision, and life insurance401(k) retirement plan with company match Quarterly bonus structure.
