Remote Clinical Appeals Specialist (PA)
UnitedHealth Group
- Remote job
UnitedHealthcare, a part of UnitedHealth Group, seeks a Physician Associate to perform clinical review and adjudication of appeals and grievances across various health plans. You will work with an integrated team including medical directors and other PAs to ensure accurate determinations and benefit interpretations. The role offers remote work from anywhere in the U.S. with standard business hours, and opportunities to contribute to process improvements and organizational committees. #J-18808-Ljbffr UnitedHealth Group
- ...Assistant/Associate to oversee appeals and grievances with a... .../HMO/Medicare plans, applying clinical criteria and medical necessity... ...outcomes. Required is an active PA license, NCCPA certification,... ...strong MS Office skills. This remote role supports US-based work hours...Remote job
- ...health care experience and improving communities. We offer remote work within the U.S. and opportunities to impact care... ...and access. The Physician Associate will conduct clinical review and adjudication of appeals and grievances, collaborate with medical directors and...Remote job
- ...Job Description Description: Job Description The Clinical Appeals Specialist reviews clinical denials involving medical necessity and clinical... ...findings appropriately. Maintain a private and secure remote work environment suitable for handling protected health...Remote work
- ...Appeals Clinical Specialist The Appeals team oversees all operational and clinical aspects of the appeals process, including intake, case processing... ...Diego Headquarters or other company location (or from a remote location with management approval based on business...Remote workFull timeWork at officeLocal areaMonday to FridayNight shiftWeekend work
$83.1k - $120.36k
Position Summary: The Appeals & Grievances (A&G) unit manages Healthfirst... ...of or delivery of clinical and non-clinical services. A&... ...compliant manner. The A&G Clinical Specialist is the subject matter expert... ...providers. This is either a remote or on-site position located at...Remote workContract workWork at officeLocal area$90k - $143k
...Clinical Solution Specialist - Patient Monitoring Bring your passion for patient care and technology... ...across the district (western upstate NY, PA, and OH) is required. Overnight stays... ...Work in an office/home office and/or remote setting, as well as in a hospital/healthcare...Remote workFull timeWork at officeImmediate startWork from homeHome officeWork visaRelocation packageFlexible hoursNight shift3 days per week$71.59k - $116.48k
A prominent healthcare organization is seeking an A&G Clinical Specialist to manage health member complaints and appeals. This fully remote position requires expertise in clinical case management, understanding of regulatory compliance, and the ability to effectively resolve...Remote job$81.1k - $116.48k
Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote Join to apply for the Appeals and Grievances Clinical Specialist - RN, LPN or Dental Hygienist - 100% Remote role at Healthfirst . Position Summary: The Appeals & Grievances (A&G) unit...Remote jobFull timeMonday to FridayShift work$73.6k - $92k
...experience across our domestic and global clinics, have allowed us to lead the change against... ...Nurse (RN) or Physician Assistant (PA) . Willingness and ability to become licensed... ...environment. Communication Skills: Outstanding remote communication, interpersonal, and patient...Remote workLocal areaImmediate startFlexible hours- ...hiring a Physician Assistant/Associate to join the appeals and grievances team. You will adjudicate cases... ...as PPO, HMO, MAPD, and PDP. The role requires a PA license, NCCPA certification, and at least five years of clinical PA practice. #J-18808-Ljbffr Texas Health...Remote job
- UnitedHealthcare offers a remote-friendly physician assistant role across... ...on review and adjudication of appeals and grievances. You will collaborate... ...design. The position requires PA licensure, NCCPA certification, and 5+ years of clinical experience, with strong MS...Remote jobWeekday work
$79.3k - $118.9k
...Clinical Retention Specialist The Clinical Retention Specialist is a clinically driven retention role focused on strengthening long term adoption... ...ability to build trust and long term relationships in a remote, phone based environment. Strong problem solving, workflow...Remote workLive inWork at officeLocal areaShift workAfternoon shift- ...PHIL Clinical Support Associate Founded in 2015, PHIL is a health... ...inquiries per day. In this fully remote position, you will handle... ...authorizations, tier exceptions, and appeals Use professionalism, de-... ..., NC, NH, NJ, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI,...Remote workWork at office
- ...you join the team as a Senior Clinical Specialist, you will support nurse... ...reimbursement support related to PA denials to improve patient care... ...Guidelines and review of PA/Appeal Denials preferred Excellent communication... ...schedule (50% in office, 50% remote). To qualify for a hybrid...Remote workTemporary workWork at officeImmediate startHome officeMonday to FridayFlexible hoursShift work
$57.7k
...Company: Highmark Inc. JOB SUMMARY This job delivers highly complex clinical and systems training courses, ongoing workshops in support of workforce development, technology and/or proprietary business systems, updates or creates course materials to reflect changes...Remote workFor contractorsReliefWork at officeLocal area- ...Veracyte, Inc. seeks a Senior Clinical Reimbursement Specialist to lead complex appeals across pre- and post-service workflows within the Clinical Reimbursement... ...driving improvements across the revenue cycle. This remote role requires strong communication with ordering...Remote work
- ...Clinical Denials Specialist Role: Clinical Denial Specialist Schedule: M - F 8 AM - 4:30 PM EST GENERAL SUMMARY: The goal of the Clinical Denial... ...for claim resubmission, retro authorization, written appeal or if no action is needed. The Clinical Denial Specialist...Remote workContract workLocal area
- ...includes but is not limited to, denial investigation, follow-up with insurance companies, billing, auditors and clinics/hospital departments, non-clinical appeal writing, accurate and timely account adjustments all while ensuring compliance with all federal, state, third-...Remote workContract workWork at officeLocal areaShift work
$72k - $108k
...Full-time Description The Clinical Systems Trainer is responsible for designing... ...adjusted for on-site support. This position is remote when not providing on-site Care Center support... ...located throughout NJ, Southeastern PA and Delaware. Travel expenses are reimbursed...Remote workFull timeTemporary workLive inWork at officeMonday to FridayFlexible hours$86.1k - $107.85k
...Senior Clinical Reimbursement Specialist Remote At Veracyte, we offer exciting career opportunities for those interested in joining a pioneering team... ...will independently manage complex pre- and post-service appeals, mentor junior team members, and drive process improvements...Remote workShift work- ...Senior Pharmacy PA/Appeals Technician Optum is a global organization that delivers care, aided by technology, to help millions of people... ...and plan details, identifies missing information, and routes clinical questions or judgment-based decisions to the appropriate...Remote jobMonday to FridayShift workAfternoon shift
- ...Inc. is seeking an Insurance Coordinator for a part-time, temporary role enabling remote work in the U.S. You will verify patient insurance, submit pre-authorization requests, manage appeals with payers, and assist with related duties in a fast-paced medical office....Remote jobTemporary workPart timeWork at office
- ...Clinical Education Specialist The Clinical Education Specialist is a field-based role responsible for training customers on the safe and effective... ..., education, life sciences, or related field. RN, LPN, NP, PA, Aesthetician, Laser Technician or equivalent....Remote workWork at office
- ...of Medicine | Radiology - General/Other Location: Pittsburgh, PA Employer: CompHealth Pay: Competitive weekly pay (... ...Please contact Madison Tourville at 954.616.2933 or send an email to remote teleradiologyMonday through Friday; no call10 weeks of PTOAt-home...Remote workWeekly payFull timeImmediate startWork from home
- ...Clinical Education Specialist – Wound Care (Northeast) Essity is a global leader in health and hygiene... ...American headquarters in Philadelphia, PA. We are a multi-billion-dollar company... ...customer accounts. This will be a remote position responsible for covering the...Remote workTemporary workWork experience placementLive inLocal areaFlexible hoursNight shift
- ...Clinical Implementation Specialist Knowtex is building the future of voice AI operating systems for clinicians, transforming how healthcare documentation... ...Background: Active clinical license (RN, NP, PA, PharmD, or equivalent) with ≥3 years of direct patient care...Remote workWork at office
$92k - $138k
Job Description SummaryThe Clinical Application Specialist (CAS) will deliver clinical and operational expertise... ...revenue thru execution of on-site or remote clinical education delivery Produce... ...modalityMust reside in the Northeast US (ideally PA or NJ).Strong verbal communication....Remote workVisa sponsorshipWork visaRelocation packageFlexible hoursNight shift- ...Senior Pharmacy PA/Appeals Technician Optum is a global organization that delivers care, aided by technology, to help millions of people... ...and plan details, identifies missing information, and routes clinical questions or judgment-based decisions to the appropriate...Remote jobTemporary workFlexible hoursShift work
- ...Clinical Education Specialist The Clinical Education Specialist will lead the development and execution... ...Preferred clinical experience such as RN, NP, PA or similar but not required. As... ...Full time Locations United States (Remote) Company CooperSurgical...Remote workFull timeWork at office
- ...Reality? Have you ever worked in a clinical setting and/or have a desire... ...the advancement of medicine appeal to you? Our mission is to... ...position called XR Clinical Specialist. The individuals we hire for... ...assistance. Provides hands on and remote clinical support to customers...Remote workContract workImmediate startRelocationFlexible hours
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