Remote Appeals & Grievances Specialist
Point32Health, Inc.
- Remote job
Point32Health, Inc. is seeking an Appeals and Grievance Coordinator to manage day-to-day tasks within the A&G department. You will process mail, assign cases, and support analysts while ensuring compliance with regulatory timelines. The role requires 1-2 years of relevant experience, strong organizational and communication skills, and proficiency in Excel and Word. A work-from-home option may be available as needed, with some on-site work in the Canton area. #J-18808-Ljbffr Point32Health, Inc.
- ...Point32Health, Inc. is seeking an Appeals and Grievance Coordinator to manage day-to-day tasks within the A&G department. You will process mail, assign cases, and support analysts while ensuring compliance with regulatory timelines. The role requires 1-2 years of relevant...Remote workWork from home
- ...A-Line Staffing Solutions in Georgia is seeking a Grievance & Appeals Coordinator I to manage the grievance and appeals workflow in a regulated... ..., accurate outcomes. This hybrid role offers office and remote work, standard business hours, and benefits after 90 days with...Remote workWork at office
- ...Managing the full life cycle of member and provider appeals and grievance cases, the full-time Appeals and Grievance Specialist will conduct case intake, investigation, and... ...to ensure timely resolution while working remotely. Key responsibilities Research and analyze case...Remote workFull timeWork at office
- ...Job Description An employer is looking for a remote Appeals & Grievances Specialist who will be responsible for managing and resolving appeals and grievances related to dental insurance claims. This role requires strong analytical and communication skills, attention...Remote workWork at office
$60.78k
...net required to achieve that purpose. Job Summary The Appeals and Grievances (A&G) Specialist II will receive, investigate and resolve member and provider... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical...Remote workLocal areaShift workWeekend work- Humana is seeking a Grievances and Appeals Representative 4 within the Internal Review Team to manage denials by reviewing clinical documentation... ...outcomes, while maintaining high productivity and strict confidentiality in a remote work setup. #J-18808-Ljbffr HumanaRemote job
$21.16 - $38.37 per hour
...Join to apply for the Medicare Appeals & Grievances Specialist (PST Hours) role at Molina Healthcare . This position is remote and will be working Pacific Standard hours. Highly Qualified Candidates Will Have The Following Experience Strong understanding of UM, Appeals...Remote workHourly payFull timeContract workWork experience placementWork at office- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote role requiring an RN, LPN, or Dental Hygienist license. Responsibilities include developing cases, researching...Remote work
- ...Centers for Medicare and Medicaid Services (CMS). Essential Job Duties Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or...Remote jobContract workWork at officeMonday to Friday
$45.9k - $78.6k
...service is the norm and every member feels valued. The Appeals & Grievances Specialist III role manages and resolves member complaints,... ...start time between 7 AM - 9 AM CT This position is a Remote role. To be eligible for consideration, candidates must have...Remote workFull timeWork experience placement- ...Member Appeals Coordinator Will the position be 100% remote? Yes. Are there any specific location requirements? No. Are there time zone requirements? Prefer... ...research and resolution of the appeals, dispute, grievances, and/or complaints from Molina members, providers...Remote workContract work
- ...Member Appeals Specialist Primary responsibilities would include triaging incoming appeals/grievances, categorizing them appropriately, assigning them to the team, making outbound calls when necessary. Also checking voicemails, responding to emails/voicemails. The...Remote workTraineeship
$21.16 - $38.37 per hour
A healthcare provider is seeking a Medicare Appeals & Grievances Specialist to handle member appeals and grievances. This remote position requires strong experience in managed care, particularly with Medicare regulations. Ideal candidates will have excellent attention...Remote workHourly payWork at office$26.99 per hour
We are currently seeking experienced Appeals & Grievances Specialists! This is a full remote opportunity paying $27/hr. The ideal candidate has experience investigating and responding in writing to internal and regulatory complaints. Experience in ACA is a plus. If...Remote workHourly payPermanent employmentTemporary workWork experience placementShift work$51k - $74.88k
...The Appeals & Grievances (A&G) unit processes member and non-contracted provider appeals for all... ...enrollments Medicare and complete care. Appeals Specialist is the subject matter expert... ...initiated cases. **This position is 100% Remote M-F 8am-5pm or 8:30pm-5pm EST. Key...Remote workFull timeTemporary workWork experience placement$48.5k - $70.5k
...year history of providing health insurance that works for our members, no matter their circumstances. Job Summary The Appeals and Grievance Specialist is responsible for managing the resolution process of medical and pharmacy member appeals and/or member generated complaints...Contract workWork at officeFlexible hours$22 - $25 per hour
...communities." Western Health Advantage Western Health Advantage (WHA) is seeking a detail-oriented and customer-focused Appeals & Grievances Specialist to join our team. In this fast-paced role, you will support members by managing appeals and grievances while ensuring...Hourly payWork experience placement$25 - $29 per hour
...Innova Solutions has a client that is immediately hiring for Appeals & Grievances Specialist Position type: Full-time - Contract Duration: 3 Months Location: Philadelphia, PA As an Appeals & Grievances Specialist, you will: Manage assigned appeals...Hourly payFull timeContract workTemporary workWork experience placementImmediate startWorldwideFlexible hours- ...denials, member and provider complaints, and reconsideration and redetermination requests. Review and respond to complaints, grievances and appeals within the stated time frame for each request. Certify that providers and members are reimbursed accordingly using...
- ...Job Title: Appeals & Grievance Specialist Job ID: 89227 Location: Boulevard, Irving Overview: The Appeals & Grievance Specialist II is responsible for independently researching, reviewing, and resolving member and provider inquiries, complaints, appeals, and grievances...Work at officeMonday to Friday
$29 per hour
...A client of Innova Solutions is immediately hiring for Appeals & Grievances Specialist Position Type: Contract to Hire Duration: 03 Months Location: Philadelphia PA As an Appeals & Grievances Specialist you will: Manage assigned appeals from case receipt...Hourly payContract workTemporary workFor contractorsWork experience placementImmediate startWorldwideFlexible hours$45.59k
...and next steps. Our partner is looking for an Appeals Specialist I based in the United States. This fully remote role offers the opportunity to support members... ...and complaints. You’ll investigate claims, grievances, disputes, and reconsideration requests while ensuring...Remote workPermanent employmentFull timeContract workMonday to Friday- At Molina Healthcare, the Claims Appeals Specialist provides support for handling member and provider complaints, aligning with CMS standards... ...focuses on researching and resolving appeals, disputes, and grievances with timely communications to authorized representatives....
- MJHS in New York, NY seeks an A&G Coordinator to investigate and respond to member and provider appeals and grievances under CMS and DOH rules. In a non-clinical role, you will help ensure timely decisions and accurate documentation. You will determine the appropriate...
- Innova Solutions in Philadelphia, PA is seeking an Appeals & Grievances Specialist for a contract-to-hire role. The position focuses on managing appeals from receipt through resolution within regulatory timelines, analyzing benefits and evidence documents, and preparing...Contract work
- A healthcare service company is seeking a G&A Coordinator in Detroit, MI. This role involves processing appeals, grievances, and inquiries from members, requiring strong analytical and communication skills. The ideal candidate will have a bachelor's degree and experience...
$28 - $35 per hour
...Location: Remote (U.S.) Preferred Location: Candidates based in or near Beachwood, OH are strongly preferred. Reports To:... ...Madison Industries, on a direct hire opportunity for a Denials & Appeals Specialist. This is a remote revenue cycle role focused on...Remote workHourly payWork at officeLocal area$25 per hour
...Job Description Job Description Job Description: The organization is seeking a dedicated and experienced Case Specialist, Grievance and Appeals to join their team on a hybrid basis. This role involves investigating and resolving member and provider complaints, benefits...Hourly payContract workWork at office- Molina Healthcare in Kentucky is seeking a Claims Support Specialist to review and resolve member and provider complaints and communicate... ...in line with CMS standards. The role involves researching appeals and grievances, requesting and reviewing medical records and bills,...Contract work
- ...Researching and responding to inquiries from various stakeholders, the full-time Appeals Specialist will manage the appeals/dispute process remotely, ensuring timely and accurate customer service and resolution of issues. Key responsibilities Provides customer service...Remote workFull timeContract workFor contractorsWork at office
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