Remote Appeals & Grievances Specialist
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 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- ...Workday is seeking a Grievance & Appeal Specialist to address appeals within required timeframes and ensure contractual obligations are met. The... ...Procedures to ensure compliance with regulatory standards. This remote position requires strong communication, confidentiality,...Remote work
$46.37k - $60.86k
...Hi, we're Oscar. We're hiring a Specialist, Admin Complaints, Grievances & Appeals to join our CGA & MPCT team. Oscar is the first health insurance company... ...into our CGA Team Lead. Work Location: This is a remote position, open to candidates who reside in: Arizona,...Remote jobFull timeWork at office$60.78k
...Appeals And Grievances Specialist II Job Category: Customer Service Department: Appeals & Grievances Location: Los Angeles, CA, US, 90017 Position... ...work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical...Remote workFull timeLocal areaShift workWeekend work- 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
$23 per hour
TEKsystems is seeking a Contract Grievances and Appeals Specialist for a fully remote role based out of Columbus, OH. The position analyzes and resolves verbal and written claims and appeals from providers and members, and prepares response letters. This is a contract...Remote jobHourly payContract work$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- ...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
$51k - $80.07k
The Appeals & Grievances (A&G) unit processes member and non-contracted provider appeals for all... ..., Medicare and complete care. Appeals Specialist is the subject matter expert responsible... ...cases. **This position is 100% Remote M-F, 8am-5pm or 8:30pm-5pm EST. Key...Remote workFull timeTemporary workWork experience placement$51k - $80.07k
The Grievance Specialist is a member of the Appeals & Grievances (A&G) team at Healthfirst and is responsible for managing and resolving member or authorized... ...regulatory requirements. **This position is 100% remote - Schedule M-F, 8am-4:30pm or 8:30am-5pm EST Key Responsibilities...Remote workFull timeContract workTemporary workWork experience placementWork at office- ...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...
- MedImpact Healthcare Systems, Inc. is seeking an Appeals and Grievances Coordinator I to manage intake, processing, notification, and compliance for appeals and grievances in a fast-paced environment. The role supports accuracy and timely processing under supervisor guidance...Weekend 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...
$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...Contract workWork at officeFlexible hours$31.25 - $33.65 per hour
...Appeals Specialist Remote GeneDx delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug discovery. The company is uniquely positioned to accelerate the use of genomic and large-scale clinical information to enable...Remote workWork at officeWork from homeHome office- ...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
$16 - $18.45 per hour
...Position: Appeals Specialist Location: Remote, US Salary: $16.00-18.45 hourly Overview J29, Inc. (J29) has been supporting commercial, State, and Federal health and human service programs since company inception in 2017 as a healthcare management consulting...Remote workHourly payFull timePart timeFor contractorsWork 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
- ...UnitedHealthcare is seeking an Appeals and Grievances Medical Director to lead clinical review and adjudication across multiple plans. The role... ...collaboration with medical directors and network management. Remote work within the U.S. is supported, with a focus on improving...Remote work
- ...Overview: Respond to all assigned levels of denials by submitting appeal letters and required documentation to insurance companies within... ...plan and work with the patient to get the denial overturned. Remote: Although this position is listed as remote, the training period...Remote work
- UT Southwestern Medical Center in Dallas, TX, seeks a Technical Denials Management Specialist II to review, research, and resolve claim denials and appeals for various insurers, maximizing collections. The role emphasizes follow-up and resolution of denied claims with...Remote job
$248.5k - $373k
...Appeals And Grievances Medical Director At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities... ...together. Work at home! You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough...Remote jobMinimum wageWork experience placementLocal areaWork from home$35.36k
...is seeking a compassionate, organized, and veteran-focused Appeals Specialist to support veterans and their families in navigating VA disability... ...you changed the life of someone who served Benefits Remote-first work, from anywhere in the USA Employer-sponsored...Remote workFull time$23.22 - $34.84 per hour
A leading health insurance provider is seeking a Grievance & Appeals Coordinator to work virtually full-time, with responsibilities including summarizing complaints, ensuring resolution of grievances, and documenting interactions. The ideal candidate should possess a high...Remote workHourly payFull time- Elevance Health is seeking an entry-level Grievance/Appeals Analyst I to review and process non-complex grievances and appeals for multiple product types and customer categories. This remote role supports flexible, compliant handling of clinical and non-clinical issues...Remote jobFlexible hours
- Banner Plans & Networks is seeking a Grievance and Appeals Coordinator to manage intake, review, investigation, and resolution of grievances,... ...providers to ensure compliant, timely responses. Position primarily remote with Arizona residency required for consideration; standard...Remote jobMonday to FridayShift work
$22.74 - $27.79 per hour
...chapter. Discover your story with Adaptive. Position Overview The Appeals Specialist is responsible for managing insurance claim appeals to ensure... ...This job is primarily completing work from a desk. #LI-Remote Compensation Hourly Rate: $22.74 - $27.79 Other...Remote workHourly payWork at officeNight shift- ...UnitedHealth Group company, is seeking a Medical Director to lead appeals and grievances clinical review for multiple health plans. The role involves... ...experience in clinical practice and quality management. Remote work options within the U.S. are available. #J-18808-Ljbffr...Remote job
- The Appeals and Grievances Medical Director at UnitedHealthcare oversees ongoing clinical review and adjudication of appeals and grievances for... ...ensure accurate benefit interpretations. This role offers full remote work across the United States, with limited in-office...Remote jobWork at office
$40.12k - $47.84k
...environment! DaVita is currently looking for a Patient Account Specialist. Individuals who excel in this role are highly... .... AND you'll never have to wear a tie again! Open to remote candidates Denials/Appeals experience preferred Candidate will be expected to...Remote workHourly payMinimum wageFull timeWork at office$22 - $23 per hour
...Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity with long-term potential and is US ( Remote ). Please review the job description below and contact me ASAP if you are interested. Job Diva ID: 26-07046 Pay Range: $22.00 -...Remote workContract workWork at officeLocal areaImmediate start
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