Workers Compensation Medical Only Examiner - Las Vegas, NV

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 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 Medical Only Examiner reviews, analyzes, investigates, makes workers compensation compensability determinations and approves the release of benefit payments up to authorized levels on initial, continued and reopened claims.

As a Workers Compensation Medical Only Examiner. You will be making 3 point contacts, reviewing diaries, completing action plans, issuing claim determinations, approving medical bills for payments, updating reserves on claims. You could also be assisting assistants and projects as needed. You are expected to attend monthly team meetings, monthly 1:1, monthly trainings You will also be utilizing claims system.

This position is full-time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm. It may be necessary, given the business need, to work occasional overtime. Our office is located at 2716 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:

• Evaluates new and on-going claims to determine compensability, medical 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 resources.
• Keeps track of statutory and internal time frames.
• This level is responsible for independently reviewing simple to moderately complex claims for adjudication purposes. Refers more complex claims to higher levels.

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 working experience
• Must be 18 years old
• 1+ years of experience adjudicating Workers Compensation claims under Nevada jurisdiction.
• Experience with Microsoft Word (to create correspondence)
• Experience with Microsoft Excel (using pre made formulas and to calculate cells)
• Experience with Microsoft Outlook (to send emails and use calendar)
• Experience with practices and procedures of case law and state Worker's Compensation laws, subrogation, reserve setting, and litigation management
• Current Nevada Workers Compensation Examiner License
• Ability to work full-time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm. It may be necessary, given the business need, to work occasional overtime.

Soft Skills:

• Ability to multi-task
• Excellent verbal and written communication skills required
• Excellent analytical and problem solving skills required

Nevada Residents Only: The hourly range for Nevada residents is $19.47 - $38.08 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth 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 UnitedHealth Group, 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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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