Member Grievances Resolution Specialist
$51k - $80.07kRemote Jobs
Healthfirst is seeking a Grievance Specialist to manage and resolve member grievances across its product lines, focusing on regulatory compliance. The role involves collaborating with multiple departments to investigate concerns and ensuring timely resolutions. The ideal candidate should have a high school diploma or GED, with preferred qualifications including a bachelor's degree and related experience. This position offers a competitive salary, with salaries ranging from $51,000 to $80,070 based on location and experience. #J-18808-Ljbffr Remote Jobs
$13.41 - $29.06 per hour
...claims activities including reviewing and resolving member and provider complaints, and communicating resolution to members or authorized representatives in... ...letters and prepares responses to member appeals and grievances. Elevates appropriate appeals to the next level...SuggestedHourly payWork experience placementWork at office- Position Summary Creates a memorable Member experience by cultivating, maintaining, and enhancing relationships with a book of business... ...about the Member’s current relationship with TDECU. Problem Resolution Owns Member issues through resolution. Troubleshoots and resolves...SuggestedLocal area
- The Senior MRS independently performs a full range of member service, sales and operational functions while requiring minimal supervision... ...regarding member issues or complaints, assisting with resolution within authority level assigned and escalating issues to a supervisor...SuggestedFull timeContract workTemporary workWork at officeFlexible hours
- ...Grievance and Appeals Specialist VillageCareMAX 112 Charles Street, New York, NY 10014 VillageCare is looking for a self-motivated individual... ...accurately and appropriately while advocating for members. The specialist will act independently and communicate with...SuggestedFull timeWork experience placementWork from home
$60k - $75k
...financial planning by prioritizing exceptional member experiences that empower individuals to... ...goals. As a Financial Operations Specialist- ACAT Transfers (internal title - Member... ...Catalog and escalate common issues and resolutions to product and engineering teams in order...SuggestedTemporary workFlexible hours- The GMR Specialist is responsible for managing and resolving member reimbursement and financial assistance cases with accuracy, efficiency, and a high level of... ...cases, ensuring accurate processing and timely resolution. Review documentation, validate eligibility, resolve...
$77.2k - $96.5k
...Overview Supervises and monitors department staff members' handling of grievances and appeals for all product lines, and ensuring compliance with... ...Will Do: Supervises the intake, investigation and resolution of appeals and grievances, member and provider, for the...Work experience placementFor subcontractorFlexible hoursWeekend work1 day per week$22 - $23 per hour
Immediate need for a Grievance & Appeals Coordinator . This is a 12+ Month Contract opportunity... ...Review, process, and resolve member appeals and grievance cases in accordance... ...gather required information and support case resolution Maintain clear and professional communication...Contract workWork at officeLocal areaImmediate startRemote work$85k - $120k
...Analyst / Associate – Recovery, Resolution & Funding Planning Treasury Division Role Overview: We are looking for a highly motivated... ...strategy. The Associate will work closely with senior team members to deliver high-quality analysis, documentation, and...Work at officeLocal areaRemote workWorldwide- Healthfirst, Inc. is seeking a MarketPlace Facilitated Enroller based in New York, NY. The role involves identifying and educating members about various health plans, completing recertification applications, and supporting members in selecting appropriate healthcare providers...Remote jobWork at office
$15 per hour
Dr. Mylissa's Medical Boutique is seeking a Member Engagement Coordinator to connect with members of various Medicare and Medicaid plans. This remote role involves making outbound calls to schedule free health evaluations, adhering to strict metrics and quality standards...Remote jobHourly pay- ...Our main location is in Brookfield, Wisconsin. Our firm is proud of our culture, transparent communication, and teamwork. As a new member, you should be looking for a challenge in a business that is quickly expanding. Responsibilities Handling outgoing and inbound calls...Remote jobWork at office
- Position Summary The Member Engagement Specialist will focus on engaging with potential members, building trust, and encouraging them to enroll in our Kidney Health Management program. Location This position is 100% remote for candidates located in the Mountain or Pacific...Remote jobWork at officeLocal areaWeekend workAfternoon shift
- NSTXL Success is seeking a Member Experience Administrator to enhance membership operations and member engagement remotely. The ideal candidate will have 1+ years of experience in administrative support or customer service, with proficiency in CRM systems like Salesforce...Remote job
$48.6k - $83.16k
...the G&A process; ensure that members have appropriate access to... ...Expedited Appeal unit, the Specialists are required to work weekends... ...authorization effectuation and resolution of cases. Perform necessary... ...aspects of the complaint, grievance and appeal process and be able...Remote jobHourly payContract workWeekend work- ...in the raw HTML. Job Description At the full performance level, major duties include: Analyze financial institution resolution strategies, under a variety of legal regimes, to address topics including restructuring, recapitalization, mergers and acquisitions...
$58.9k - $80.07k
...Marketplace Facilitated Enroller The MarketPlace Facilitated Enroller is responsible for identifying and educating potential members on all aspects of the plan including new Medicaid, CHP/EP/QHP and answering questions regarding plan's features and benefits. Responsible...Temporary workWork experience placementWork at officeRemote workAfternoon shift- A healthcare organization is seeking a Member Engagement Specialist to engage potential members and encourage them to enroll in a Kidney Health Management program. This fully remote position requires a high school diploma and 2 years of relevant experience in sales or...Remote job
$25 - $35 per hour
...real life. About the Role OurRitual is launching a new Concierge Model designed to give every member a guided, personalized start to their journey. As a Member Matching Specialist, you will be the first human touchpoint for new members, setting the tone for their...Hourly payPart timeFlexible hoursAfternoon shift- A financial services firm is seeking a Member Experience Specialist to provide high-touch support via phone, email, and Zoom, guiding members through investment processes with empathy and professionalism. The role requires strong communication skills and experience in...Remote jobFlexible hours
- ...meaningful work that will impact tons of people through the family-building process. What we're looking for We are hiring a Member Outreach Specialist to support our Clinical Operations and Matchmaking teams in guiding members through their egg donation journeys. This is...Local areaRemote workWeekend workWeekday work
$17 - $33.13 per hour
Municipal Credit Union seeks a Part-Time Member Service Representative in New York. This role is key in ensuring excellent service to members by addressing their needs and executing various transactions. Responsibilities include conducting member interviews, processing...Hourly payPart timeFlexible hours$16 - $17 per hour
Crunch Fitness is seeking a Front Desk Agent in New York City to create an outstanding first impression and deliver an exceptional member experience. The role involves greeting members, conducting facility tours, and checking members in while ensuring a welcoming environment...Hourly payPart time- ...services provider in New York is seeking a Customer Success Representative for a 3-month contract. This role is pivotal in supporting members throughout their healthcare journey, particularly in member retention and enrollment. Ideal candidates should possess a High School...Contract work
$75 per hour
...EXTRAORDINARY – BECOME A BEHAVIORAL INTERVENTION SPECIALIST WITH KIDS IN THE GAME!Support Staff.... ...—campers, families, staff, community members, and our partners. We're looking for... ...during behavioral incidents and conflict resolution situationsCollaborate with camp leadership...Full timeSummer workSeasonal workMonday to Friday- ...site is also home to key marketing programs including NYC Restaurant Week, NYC Broadway Week, and more. POSITION SUMMARY The Specialist, Member Programs & Services, supports member engagement, retention, and program participation by serving as a day‑to‑day resource for...Work at officeRemote workWork visaFlexible hours
- ...La Central YMCA in Bronx, NY. The role emphasizes providing excellent customer service, engaging with the community, and managing member interactions with a focus on building rapport and credibility. Candidates should have a high school diploma and 2-3 years of customer...Part time
$62.29k - $75k
...with timely and effective solutions. Assist with other functions within the department to meet service level agreements. Execute all member service-related tasks within the department effectively and accurately. This position is expected to be hybrid, 2 days a week in...Work experience placementWork at officeLocal area2 days per week$17.34 - $19 per hour
The YMCA of Greater New York is looking for a Member Experience Representative at the Flatbush YMCA in Brooklyn. This full-time position involves providing exceptional service to members and guests, processing transactions accurately, and building community relationships...Hourly payFull time- Progyny, Inc in New York is seeking a GMR Specialist responsible for managing member reimbursement and financial assistance cases. This role involves ensuring the accurate processing of claims and payments, reviewing eligibility, and communicating outcomes. The ideal candidate...
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