Medicare MSP Disputes & Appeals Specialist (Remote)
Sanderson Firm
- Remote job
Sanderson Firm, a women-owned MSP compliance specialist, seeks a Medicare Coding Specialist to research, dispute, and finalize reimbursement obligations for clients nationwide. You will interact with Medicare recovery contractors, Advantage plans, and subrogation contractors, applying complex medical and legal reasoning to support dispute strategies. This remote-friendly role requires strong analytical skills, attention to detail, and excellent written and verbal communication. #J-18808-Ljbffr Sanderson Firm
$50k - $60k
...funded and fully funded programs, and delivered tangible savings and enhanced experiences for millions of members. The Appeals & Disputes Specialist is responsible for reviewing, investigating, and resolving member appeals and provider disputes for benefit plans,...Remote workFull timeWork at office- Reflect Health is seeking an Appeals & Disputes Specialist to review, investigate, and resolve member appeals and provider disputes with a focus on compliant and timely determinations. This remote role supports plan interpretation, coding review, and collaboration with...Remote job
- Reflect Health, an independent administrator, seeks an Appeals & Disputes Specialist for remote work. You will review, investigate, and resolve member appeals and provider disputes, ensuring accurate, timely determinations in line with plan documents and regulations. The...Remote job
$60.78k
...Appeals and Grievances Specialist IIJob Category: Customer Service Department: Appeals... ...compliance with Centers for Medicare and Medicaid Services (CMS... ...complex provider claim disputes. The position is further responsible... ..., holidays, a hybrid remote schedule, occasional...Remote workFull timeLocal areaShift workWeekend work$30.7k - $66.5k
...with the standards and requirements established by the 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...Remote workFull timeContract workWork at office- Banner Plans & Networks in Arizona seeks a Grievance and Appeals Coordinator to manage the intake, review, investigation, and resolution of member grievances, appeals, and provider disputes in a remote setting. Candidates must reside in Arizona; you will document findings...Remote job
- Sanderson Firm seeks a Medicare Coding Specialist to research, dispute, and finalize potential reimbursement obligations for clients. The role involves coordinating... ...strong communication skills, and the ability to work remotely in a fast-paced environment. #J-18808-Ljbffr...Remote jobFor contractors
- Appeals Specialist (LPN, RN, or Therapist) Location: Massachusetts (RegalCare Facility network / Hybrid-Remote options available) Position Type: Full-Time Role Overview... ...insurance denials, Medicare/Medicaid rejections, and managed care disputes. Gather clinical evidence...Remote workFull time
- ...accordance with the standards and requirements established by the 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...Remote jobContract workWork at office
- ...life balance. For most jobs, remote work is available for 9 out... ...workdays. Job Description The Appeals Specialist I position plays a critical... ...and the PEHP Provider Dispute Review Committee. This role... ...pharmacy, mental health, and Medicare Supplement claims, adjudication...Remote workWork at office
- Job Category Appeals, Grievances, Specialist Employee Type Exempt - FT Manage Others No Contact information... ...grievances, and appeals. This fully remote position focuses primarily on... ...Harbor Health departments to evaluate disputed issues and ensure appropriate adjudication...Remote workHome office
$66k - $68k
WPS, a health solutions company, seeks an Appeals Nurse to review first-level appeal cases, assess medical necessity, and prepare rationale... ...and communication skills are essential. The role offers remote work options across approved states, with a base salary in the...Remote job- WPS is seeking an Appeals Nurse to review medical records and Medicare claim information for first-level appeal cases. You will collaborate with Appeals Examiners... ...license, ASN/BSN, and 1+ year clinical experience. Remote work is permitted in several states, including New...Remote job
- ...Network Health is seeking an Appeals and Grievance Specialist I to join our Wisconsin team. The role reviews member appeals, investigates findings... ...strong communication and regulatory interpretation skills. Remote 1.0 FTE, with occasional travel to offices in Menasha or...Remote work
- ...University Physicians is seeking a Revenue Recovery Specialist to analyze denials, prepare reconsiderations, and file appeals to improve revenue recovery. The role requires... ...patient accounts, with opportunities to work remotely under the university's work-from-home program....Remote jobWork from home
$56.27k - $69.9k
Pay Plan Title: Appeals or Grievances Specialist II Working Title: Appeals Specialist II FLSA Status: Exempt Posting Salary Range: $56,270 - $69,898 Office Location: Remote within North Carolina POSTING DETAILS: Make an Impact Trillium Health Resources is...Remote workFull timeWork at officeLocal areaImmediate startWork from homeFlexible hours- UT Southwestern Medical Center is seeking a Technical Denials Management Specialist II in the Revenue Cycle Department to review, research, and resolve claim denials and appeals for various insurers, while identifying payment trends to maximize collections. This WFH role...Remote jobWork at officeWork from home
$29.7 - $31.8 per hour
## Acute Coding Appeals SpecialistApply: Remote - Nationwide: Full time: Posted Today: R052289**Thank you for considering a career at Ensemble!*... ...70 - $31.80 based on experienceThe Acute Coding Appeals Specialist integrates medical coding principles and objectivity in...Remote workFull timeTemporary workWork at officeLocal area$19.13 - $34.17 per hour
...Adjudicating Complex Non-Utilization. Management Appeals According To The Appropriate Federal,... ...And Mentor Less Experienced Appeals Specialists. JOB REQUIREMENTS: * High School... ...plan. This position may be performed remotely from anywhere within the continental United...Remote work- Credit Key is seeking an Account Resolution Specialist to independently manage dispute and fraud cases on past-due accounts. You will own investigations,... ...communication with a collaborative team. This position offers a remote work option within the United States, with a focus on...Remote work
- Harbor Health in Texas seeks an Appeals & Grievances Specialist to investigate, process, and resolve member and provider complaints, grievances, and appeals. This fully remote role focuses on Texas IFP/Marketplace and large-group products, ensuring timely investigations...Remote job
- Humana, Inc. is seeking a Grievances & Appeals Representative to assist members and providers with grievance and appeal inquiries, investigate... ...The role supports quality and member experience goals within a remote, production-driven environment. Typical duties include applying...Remote job
- ...Organization is seeking an Accounts Receivable Resolution Specialist in the United States for a fully remote, full-time role to ensure accurate insurance claims... ...AR cases, investigate denials, and coordinate appeals to accelerate payments from insurers and third-party...Remote jobFull time
- Blue Cross and Blue Shield of Kansas seeks a MA Appeals and Grievances Specialist to process and resolve member, provider, and representative appeals... ...world-class customer service. The role supports remote or onsite work per policy; candidates must reside in Kansas...Remote jobRelocation
- ...the United States, seeks an Accounts Receivable Resolution Specialist for a fully remote, full-time role focused on insurance claims follow-up and... ...providers, patients, and insurers to resolve payments, process appeals in WAYSTAR, and accelerate reimbursements while...Remote jobFull time
- Aspirion is seeking a Denials Appeals Specialist to analyze, draft, and submit high-quality appeal letters for denied claims. You will identify root causes, correct errors, and file appeals per payer guidelines to support cash flow and reduce accounts receivable aging....Remote job
- Mosaic Life Care is seeking a CDI Nurse Specialist to support clinical documentation integrity across our care teams. You will review, query and appeal to ensure accurate coding and appropriate DRG assignments, collaborating with physicians and coders. The role emphasizes...Remote job
- 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
- Brown University Health is seeking a Denials Management Specialist in Rhode Island. The role focuses on maximizing reimbursement by analyzing... ...initiatives related to denials reduction. You will handle appeals with third-party payers, coordinate with hospital departments,...Remote job
- ...Documentation Improvement focus to perform CDI reviews, coding, and denial appeals. The role requires collaboration with physicians, managers, and... ...and coding for patient cases. The position supports remote work for qualifying states, including Nebraska, with...Remote job
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